Adekunle Ajayi E, Akintomide Anthony O
Department of Internal Medicine, University Teaching Hospital, Ado Ekiti, Nigeria.
Ann Afr Med. 2012 Apr-Jun;11(2):96-102. doi: 10.4103/1596-3519.93532.
Exercise capacity, like some other variables of exercise stress test, is a strong predictor of cardiovascular and overall mortality. Many confounding factors, including gender, have been found to affect exercise capacity. This study evaluated whether exercise capacity differs in age-matched type 2 diabetic Nigerian men and their women counterparts and the hemodynamic variables of exercise treadmill test that correlate with exercise capacity in them.
A total of 61 type 2 diabetics (male = 34; female = 27) aged 30 to 60 years who were recruited through the Medical Out-patient Department of OAUTHC, Ile Ife, Nigeria, underwent symptom-limited maximal treadmill exercise using Bruce protocol.
Patients had comparable clinical and demographic patterns. There was no gender difference in the chronotropic response to exercise. Males had faster heart rate recovery (HRR) than females. Though both sexes had similar resting systolic blood pressure (SBP), males had significantly higher peak SBP than females (216.2 ± 23.7 mmHg vs 203.3 ± 21.7 mmHg; P = 0.03). Exercise capacity was significantly higher in males (7.5 ± 2.0 METs) than females (6.4 ± 1.5 METs); P = 0.01. Significant correlates of exercise capacity in both sexes were fasting plasma glucose, resting diastolic blood pressure, Duke Treadmill Score, and HRR. Majority of the patients were in moderate DUKE risk subgroup and there was no statistically significant difference between males and females in this regard.
Gender difference occurs in the exercise capacity of diabetic patients and the factors associated with this disparity may be related to gender differences in resting heart rate and HRR, both reflecting a withdrawal of vagal tone.
运动能力与运动应激试验的其他一些变量一样,是心血管疾病和全因死亡率的有力预测指标。已发现许多混杂因素,包括性别,会影响运动能力。本研究评估了年龄匹配的尼日利亚2型糖尿病男性和女性的运动能力是否存在差异,以及运动平板试验中与他们的运动能力相关的血流动力学变量。
通过尼日利亚伊费奥塔乌图阿教学医院门诊部招募了61名年龄在30至60岁之间的2型糖尿病患者(男性34名;女性27名),使用布鲁斯方案进行症状限制的最大平板运动试验。
患者具有可比的临床和人口统计学特征。运动时的变时反应没有性别差异。男性的心率恢复(HRR)比女性快。虽然两性的静息收缩压(SBP)相似,但男性的峰值SBP显著高于女性(216.2±23.7 mmHg对203.3±21.7 mmHg;P = 0.03)。男性的运动能力(7.5±2.0梅脱)显著高于女性(6.4±1.5梅脱);P = 0.01。两性运动能力的显著相关因素为空腹血糖、静息舒张压、杜克运动平板评分和HRR。大多数患者属于中度杜克风险亚组,在这方面男性和女性之间没有统计学显著差异。
糖尿病患者的运动能力存在性别差异,与这种差异相关的因素可能与静息心率和HRR的性别差异有关,两者均反映迷走神经张力的减退。