Werneck Francisco Zacaron, Coelho Emerson Filipino, de Lima Jorge Roberto Perrout, Laterza Mateus Camaroti, Barral Marselha Marques, Teixeira Patrícia de Fátima Dos Santos, Vaisman Mário
1 Endocrine Service, Federal University of Rio de Janeiro , Rio de Janeiro, Brazil .
Thyroid. 2014 Jun;24(6):931-8. doi: 10.1089/thy.2013.0534. Epub 2014 Mar 21.
Patients with subclinical hypothyroidism (SCH) have lower exercise tolerance, but the impact on oxygen uptake (VO2) kinetics is unknown. This study evaluated VO2 kinetics during and after a constant load submaximal exercise in SCH.
The study included 19 women with SCH (thyrotropin (TSH)=6.87±2.88 μIU/mL, free thyroxine (fT4)=0.97±0.15 ng/dL) and 19 controls (TSH=2.29±0.86 μIU/mL, T4=0.99±0.11 ng/dL) aged between 20 and 55 years. Ergospirometry exercise testing was performed for six minutes with a constant load of 50 W, followed by six minutes of passive recovery. The VO2 kinetics was quantified by the mean response time (MRT), which is the exponential time constant and approximates the time needed to reach 63% of change in VO2 (ΔVO2). The O2 deficit-energy supplied by anaerobic metabolism at the onset of exercise-and O2 debit-extra energy demand during the recovery period-were calculated by the formula MRT×ΔVO2. Values are mean±standard deviation.
In the rest-exercise transition, patients with SCH showed slower VO2 kinetics (MRT=47±8 sec vs. 40±6 sec, p=0.004) and a higher oxygen deficit (580±102 mL vs. 477±95 mL, p=0.003) than controls respectively. In the exercise-recovery transition, patients with SCH also showed slower VO2 kinetics (MRT=54±6 sec vs. 44±6 sec, p=0.001) and a higher oxygen debit (679±105 mL vs. 572±104 mL, p=0.003). The VO2 kinetics showed a significant correlation with TSH (p<0.05).
This study demonstrates that women with SCH have the slowest VO2 kinetics in the onset and recovery of a constant-load submaximal exercise and highlights that this impairment is already manifest in the early stage of the disease.
亚临床甲状腺功能减退症(SCH)患者的运动耐力较低,但对摄氧量(VO2)动力学的影响尚不清楚。本研究评估了SCH患者在恒负荷次最大运动期间及之后的VO2动力学。
该研究纳入了19名年龄在20至55岁之间的SCH女性患者(促甲状腺激素(TSH)=6.87±2.88 μIU/mL,游离甲状腺素(fT4)=0.97±0.15 ng/dL)和19名对照者(TSH=2.29±0.86 μIU/mL,T4=0.99±0.11 ng/dL)。采用功率呼吸运动测试,以50 W的恒定负荷进行6分钟运动,随后进行6分钟的被动恢复。VO2动力学通过平均反应时间(MRT)进行量化,MRT是指数时间常数,近似于达到VO2变化(ΔVO2)的63%所需的时间。通过公式MRT×ΔVO2计算运动开始时无氧代谢提供的氧亏和恢复期额外的氧债。数值为平均值±标准差。
在静息-运动转换过程中,SCH患者的VO2动力学较慢(MRT=47±8秒 vs. 40±6秒,p=0.004),氧亏高于对照组(580±102 mL vs. 477±95 mL,p=0.003)。在运动-恢复转换过程中,SCH患者的VO2动力学也较慢(MRT=54±6秒 vs. 44±6秒,p=0.001),氧债更高(679±105 mL vs. 572±104 mL,p=0.003)。VO2动力学与TSH呈显著相关性(p<0.05)。
本研究表明,SCH女性患者在恒负荷次最大运动的开始和恢复阶段VO2动力学最慢,并强调这种损害在疾病早期就已显现。