Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 151, 00185, Rome, Italy.
J Endocrinol Invest. 2017 Sep;40(9):999-1005. doi: 10.1007/s40618-017-0670-6. Epub 2017 Apr 6.
Physical activity is an effective therapeutic tool for cardiovascular risk prevention. However, exercise aerobic capacity of patients with type 1 diabetes (T1DM) has not been thoroughly investigated. Aim of the present study is to evaluate exercise aerobic capacity in patients with T1DM compared to a normal control population.
This observational study included 17 T1DM patients and 17 matched healthy volunteers. Cardiopulmonary exercise test (CPET) was conducted on an electronically-braked cycle ergometer. Blood samples were collected for evaluation of glycemia and lactate levels.
Mean oxygen uptake at peak exercise (V'O) was significantly lower in T1DM subjects (V'O T1DM 2200 ± 132ml/min vs V'O Healthy subjects of 2659 ± 120 ml/min p = 0.035). Cardiovascular response analysis did not show statistically significant differences. Respiratory exchange ratio (RER) was significantly higher in healthy subjects at peak exercise and at the first minute of recovery (p = 0.022, p = 0.024). Peak exercise lactate levels were significantly higher in healthy subjects. There was no statistical correlation between CPET results and diabetes-related parameters.
Patients affected by T1DM have a worse exercise tolerance than normal subjects. The two groups differed by RER which can be greatly influenced by the substrate type utilized to produce energy. Because of the impaired carbohydrate utilization, T1DM subjects may use a larger amount of lipid substrates, such hypothesis could be strengthened by the lower lactate levels found in T1DM group at peak exercise. The lack of correlation between exercise tolerance and disease-related variables suggests that the alterations found could be independent from the glycemic levels.
身体活动是预防心血管风险的有效治疗工具。然而，1 型糖尿病（T1DM）患者的运动有氧能力尚未得到充分研究。本研究旨在评估 T1DM 患者与正常对照组相比的运动有氧能力。
这项观察性研究纳入了 17 名 T1DM 患者和 17 名匹配的健康志愿者。心肺运动测试（CPET）在电子制动的自行车测力计上进行。采集血样以评估血糖和乳酸水平。
T1DM 受试者在峰值运动时的平均摄氧量（V'O）明显较低（V'O T1DM 2200 ± 132ml/min 与 V'O 健康受试者 2659 ± 120 ml/min，p=0.035）。心血管反应分析未显示出统计学上的显著差异。在峰值运动和恢复的第一分钟，健康受试者的呼吸交换率（RER）明显较高（p=0.022，p=0.024）。健康受试者在峰值运动时的乳酸水平明显较高。CPET 结果与糖尿病相关参数之间没有统计学相关性。
患有 T1DM 的患者的运动耐量比正常受试者差。两组之间的 RER 存在差异，RER 可以受到用于产生能量的底物类型的极大影响。由于碳水化合物利用受损，T1DM 患者可能使用更多的脂质底物，这种假设可以通过在 T1DM 组中发现的较低的乳酸水平得到加强。运动耐量与疾病相关变量之间缺乏相关性表明，发现的改变可能与血糖水平无关。
