PURPOSE. The purpose of the present retrospective study was to observe the different alterations in pulmonary function and exercise capacity in non-alcoholic Steatohepatitis (NASH) with and without diabetes 

METHODS. This study was conducted using the Mayo Clinic patient database and selected NASH patients with and without diabetes who underwent pulmonary function test (PFT) and cardiopulmonary exercise test (CPET) within a similar timeline. Patients who had major comorbidities including cardiovascular or pulmonary diseases were excluded. The 70 subjects were divided into 2 groups: NASH with diabetes (n=43) and NASH without diabetes (n=27). Analysis was performed to compare key parameters of pulmonary function, exercise capacity and blood markers between groups. 

RESULTS. For liver function, there were no significant differences in alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin and bilirubin between groups (p>0.05). In addition, NASH with diabetes demonstrated lower triglyceride (TG) and cholesterol than NASH without diabetes (p<0.05) while they showed higher fasting blood glucose (FBG) and hemoglobin A1C (HbA1C) relative to NASH without diabetes (p<0.05). For pulmonary function, NASH with diabetes showed lower forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1) and FEV1/FVC than NASH without diabetes (p<0.05). Moreover, for exercise capacity, NASH with diabetes demonstrated lower peak oxygen uptake (VO2peak) and higher HR at a given VO2 (HR/VO2) relative to NASH without diabetes (p<0.05). 

CONCLUSIONS. Diabetes may further exacerbate impairments of pulmonary function and exercise capacity in NASH.