Key result
A five-variable clinical model explains ~39% of 6-minute walk distance variance in chronic liver disease.
Why the study?
The relationship between physical performance and metabolic and inflammatory measures in people with chronic liver disease was not well characterized.
Cohort (n=51)
Older age, female sex, abnormal IL-8, abnormal glucose metabolism, and high resting heart rate are associated with poor physical performance in patients with chronic liver disease.
Poor 6MWT performance was associated with IL-8 and glucose abnormalities in chronic liver disease; leaves open whether targeting these markers improves function.
OBJECTIVE: The aim of this study was to assess whether physical performance correlates with metabolic and inflammatory measures in research subjects with chronic liver disease. DESIGN: This is a prospective, descriptive cohort study correlating performance on a 6-min walk test with cardiorespiratory variables, metabolic measures (glucose [GLU], C-peptide insulin, and lipids), liver enzymes (aspartate aminotransferase and alanine aminotransferase), and the proinflammatory cytokine interleukin-8 (IL-8). RESULTS: This study enrolled 51 subjects (18 women) with chronic liver disease: 41% (n = 21) with nonalcoholic fatty liver disease and 59% (n = 30) with hepatitis C virus. Age, resting heart rate, and fasting GLU correlated significantly with distance walked (P's < 0.05). First quartile "poor performers" (n = 14) and fourth quartile "high performers" (n = 14) showed differences in age, sex, fasting GLU, and IL-8 level (P's < 0.05). Combining the number of abnormal serum values (IL-8, C-peptide insulin, GLU, aspartate aminotransferase, alanine aminotransferase, high-density lipoprotein, triglyceride, and total cholesterol) did not correlate with distance walked (P > 0.90). However, in multiple regression analysis, a model that included sex, age, resting heart rate, IL-8 level, and fasting GLU level explained approximately 39% of the variance in the distance walked during the test. CONCLUSIONS: Older age, female sex, abnormal levels of the proinflammatory cytokine IL-8, abnormalities of GLU metabolism, and high resting heart rate are associated with poor physical performance in subjects with chronic liver disease. Poor physical performance is associated with physiologic, metabolic, and inflammatory abnormalities in subjects with nonalcoholic fatty liver disease and hepatitis C virus.
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Loria et al. (2014) conducted a cohort in chronic liver disease (n=51). Physiologic, metabolic, and inflammatory abnormalities was evaluated on distance walked on a 6-min walk test (39% of variance explained, p=< 0.05). A model including sex, age, resting heart rate, IL-8 level, and fasting glucose explained approximately 39% of the variance in 6-minute walk distance in patients with chronic liver disease.
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