Diabetes Research Group, Medical School, Swansea University, Swansea, United Kingdom.
Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea, United Kingdom.
PLoS One. 2018 Apr 2;13(4):e0194750. doi: 10.1371/journal.pone.0194750. eCollection 2018.
This study investigated the degree and direction (kHR) of the heart rate to performance curve (HRPC) during cardio-pulmonary exercise (CPX) testing and explored the relationship with diabetes markers, anthropometry and exercise physiological markers in type 1 diabetes (T1DM).
Sixty-four people with T1DM (13 females; age: 34 ± 8 years; HbA1c: 7.8 ± 1% (62 ± 13 mmol.mol-1) performed a CPX test until maximum exhaustion. kHR was calculated by a second-degree polynomial representation between post-warm up and maximum power output. Adjusted stepwise linear regression analysis was performed to investigate kHR and its associations. Receiver operating characteristic (ROC) curve was performed based on kHR for groups kHR < 0.20 vs. > 0.20 in relation to HbA1c.
We found significant relationships between kHR and HbA1c (β = -0.70, P < 0.0001), age (β = -0.23, P = 0.03) and duration of diabetes (β = 0.20, P = 0.04). Stepwise linear regression resulted in an overall adjusted R2 of 0.57 (R = 0.79, P < 0.0001). Our data revealed also significant associations between kHR and percentage of heart rate at heart rate turn point from maximum heart rate (β = 0.43, P < 0.0001) and maximum power output relativized to bodyweight (β = 0.44, P = 0.001) (overall adjusted R2 of 0.44 (R = 0.53, P < 0.0001)). ROC curve analysis based on kHR resulted in a HbA1c threshold of 7.9% (62 mmol.mol-1).
Our data demonstrate atypical HRPC during CPX testing that were mainly related to glycemic control in people with T1DM.
本研究调查了 1 型糖尿病（T1DM）患者在心肺运动（CPX）测试中心率与运动表现曲线（HRPC）的程度和方向（kHR），并探讨了其与糖尿病标志物、人体测量学和运动生理学标志物的关系。
64 名 T1DM 患者（13 名女性；年龄：34 ± 8 岁；HbA1c：7.8 ± 1%（62 ± 13 mmol/mol）进行了 CPX 测试，直至达到最大耗氧量。kHR 通过预热后和最大功率输出之间的二次多项式表示来计算。进行逐步线性回归分析以研究 kHR 及其相关性。根据 kHR 进行受试者工作特征（ROC）曲线分析，将 kHR < 0.20 组与 kHR > 0.20 组与 HbA1c 进行比较。
我们发现 kHR 与 HbA1c（β = -0.70，P < 0.0001）、年龄（β = -0.23，P = 0.03）和糖尿病病程（β = 0.20，P = 0.04）之间存在显著关系。逐步线性回归得到的总体调整 R2 为 0.57（R = 0.79，P < 0.0001）。我们的数据还显示，kHR 与最大心率时心率转折点的心率百分比（β = 0.43，P < 0.0001）和最大相对体重功率输出（β = 0.44，P = 0.001）之间存在显著相关性（总体调整 R2 为 0.44（R = 0.53，P < 0.0001））。基于 kHR 的 ROC 曲线分析得到的 HbA1c 阈值为 7.9%（62 mmol/mol）。
我们的数据表明，1 型糖尿病患者 CPX 测试中的 HRPC 不典型，主要与血糖控制有关。
