Abstract
Purpose
Impaired cardiorespiratory fitness (CRF) is a predictor of mortality in patients with type 2 diabetes mellitus (T2DM). It is still not known how the exercise hemodynamic response correlates with CRF. The purpose was to assess the correlation between hemodynamic changes and CRF in middle-aged patients with T2DM.
Methods
After 1:1 matching by age and sex, 139 T2DM patients and 139 non-T2DM controls who completed the exercise treadmill test were included. Maximal aerobic capacity (VO2max), exercise-induced changes in heart rate (ΔHR), systolic blood pressure (ΔSBP), diastolic blood pressure (ΔDBP), and rate-pressure product (ΔRPP) were measured. HRR1 was calculated as the maximum heart rate minus the heart rate after 1 min of rest.
Results
Compared to the control population, T2DM patients had decreased ΔHR (87 (77, 97) v 93 (84, 104) bpm, p < 0.05), ΔRPP (3833.64 ± 1670.34 v 4381.16 ± 1587.78 bpm∙mmHg, p < 0.05), HRR1 (21 (14, 27) v 21 (17, 27) bpm, p < 0.05), and VO2max (32.76 ± 5.63 v 34.68 ± 5.70 ml/kg/min, p < 0.05). Multiple linear regression analysis showed that ΔHR and HRR1, yielded a positive correlation with VO2max in T2DM patients (β = 0.325, P < 0.001; β = 0.173, P = 0.01).
Conclusion
The presence of impaired hemodynamic response and VO2max in middle-aged T2DM patients and the association of impaired ΔHR, HRR1, and VO2max may indicate a physiological pathway of impaired CRF, and our results support the need for cardiorespiratory screening and individualized treatment of middle-aged T2DM patients.
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Data availability
Due to the privacy of the participants involved in this study, the data sets used and/or analyzed in this study are not publicly available, but can be obtained from the corresponding authors upon reasonable request.
Abbreviations
- ANS:
-
Autonomic Nervous System
- ANSI:
-
Autonomic Nervous System Index
- BMI:
-
Body mass index
- CRF:
-
Cardiorespiratory fitness
- CAN:
-
Cardiac autonomic neuropathy
- DBP :
-
Diastolic blood pressure
- HR:
-
Heart rate
- HDL:
-
High density lipoprotein
- HRV:
-
Heart rate variability
- LDL:
-
Low density lipoprotein
- RPP :
-
Rate-pressure product
- SBP:
-
Systolic blood pressure
- T2DM:
-
Type 2 diabetes mellitus
- VO2max :
-
Maximal aerobic capacity
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Acknowledgements
The authors are very grateful to The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine for their support of the data and to all participants for their contributions.
Funding
This work was supported by the Key Research and Development Project funded by the Ministry of Science and Technology of the People’s Republic of China (Grant Number: 2019YFC1710301).
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LHY and JH contributed to study design, and data collection and analysis were performed by YX, YNC, and JWQ. The first draft of the manuscript was written by JJX. All authors read and approved the final manuscript.
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The study was approved by the Ethics Committee of The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine and the procedures used in this study adhere to the tenets of the Declaration of Helsinki.
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Communicated by Massimo Pagani.
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Xie, J., Yin, L., Huang, J. et al. Correlation between impaired hemodynamic response and cardiopulmonary fitness in middle-aged type 2 diabetes mellitus patients: a case–control study. Eur J Appl Physiol 122, 2295–2303 (2022). https://doi.org/10.1007/s00421-022-05008-z
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DOI: https://doi.org/10.1007/s00421-022-05008-z