Abstract：
Although the link between hepatic steatosis and lung function has been confirmed, the focus has largely been on central airways. The association between hepatic steatosis and increased peripheral airway resistance has not yet been explored. Hepatic steatosis and increased peripheral resistance are connected with immunity dysregulation. High neutrophil-to-lymphocyte ratio (NLR) and low lymphocyte-to-monocyte ratio (LMR) have been recognized as indicators of immunity dysregulation. In this study, the association between hepatic steatosis and increased peripheral airway resistance was evaluated, and the effect of immunity dysregulation (high NLR/low LMR) on the increased peripheral airway resistance among patients with hepatic steatosis was explored. In this retrospective study, chest or abdomen CT scans and spirometry/impulse oscillometry (IOS) from 2018 to 2019 were used to identify hepatic steatosis and increased central/peripheral airway resistance in patients. Among 1391 enrolled patients, 169 (12.1%) had hepatic steatosis. After 1:1 age and abnormal ALT matching was conducted, clinical data were compared between patients with and without hepatic steatosis. A higher proportion of patients with hepatic steatosis had increased peripheral airway resistance than those without hepatic steatosis (52.7% vs 40.2%, P = .025). Old age, high body mass index, history of diabetes, and high NLR/low LMR were significantly correlated with increased peripheral airway resistance. The presence of hepatic steatosis is associated with increased peripheral airway. High NLR/low LMR is an independent associated factor of increased peripheral airway resistance in patients with hepatic steatosis. It is advisable for patients with hepatic steatosis to regularly monitor their complete blood count/differential count and undergo pulmonary function tests including IOS.
摘要：
虽然肝脂肪变性和肺功能之间的联系已经得到证实，重点主要是中央气道。肝脂肪变性与周围气道阻力增加之间的关联尚未被探索。肝脏脂肪变性和外周阻力增加与免疫失调有关。高中性粒细胞与淋巴细胞比率（NLR）和低淋巴细胞与单核细胞比率（LMR）已被认为是免疫失调的指标。在这项研究中,评估了肝脏脂肪变性与周围气道阻力增加之间的关系，探讨了免疫失调（高NLR/低LMR）对肝性脂肪变性患者外周气道阻力增加的影响。在这项回顾性研究中,2018年至2019年的胸部或腹部CT扫描和肺活量测定/脉冲振荡法(IOS)用于识别患者的肝脂肪变性和中央/外周气道阻力增加.在1391名患者中，169例（12.1%）有肝脂肪变性。1:1年龄和异常ALT匹配后，比较有和没有肝性脂肪变性的患者的临床资料.与没有肝性脂肪变性的患者相比，肝性脂肪变性患者的外周气道阻力增加的比例更高（52.7％vs40.2％，P=.025）。老年,高体重指数,糖尿病史,高NLR/低LMR与周围气道阻力增加显著相关。肝性脂肪变性的存在与外周气道增加有关。高NLR/低LMR是肝性脂肪变性患者外周气道阻力增加的独立相关因素。建议肝性脂肪变性患者定期监测其全血计数/分类计数，并进行包括IOS在内的肺功能检查。
