Division of Cardiology, University of Colorado School of Medicine, Aurora, CO.
Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX.
Diabetes Care. 2019 Jul;42(7):1333-1339. doi: 10.2337/dc18-2634. Epub 2019 May 21.
Lifestyle intervention remains the cornerstone of management of type 2 diabetes mellitus (T2DM). However, adherence to physical activity (PA) recommendations and the impact of that adherence on cardiorespiratory fitness in this population have been poorly described. We sought to investigate adherence to PA recommendations and its association with cardiorespiratory fitness in a population of patients with T2DM.
A cross-sectional analysis of baseline data from a randomized clinical trial (NCT00424762) was performed. A total of 150 individuals with medically treated T2DM and atherosclerotic cardiovascular disease (ASCVD) or risk factors for ASCVD were recruited from outpatient clinics at a single academic medical center. All individuals underwent a graded maximal exercise treadmill test to exhaustion with breath-by-breath gas exchange analysis to determine VO. PA was estimated using a structured 7-Day Physical Activity Recall interview.
Participants had a mean ± SD age of 54.9 ± 9.0 years; 41% were women, 40% were black, and 21% were Hispanic. The mean HbA was 7.7 ± 1.8% and the mean BMI, 34.5 ± 7.2 kg/m. A total of 72% had hypertension, 73% had hyperlipidemia, and 35% had prevalent ASCVD. The mean ± SD reported daily PA was 34.3 ± 4 kcal/kg, only 7% above a sedentary state; 47% of the cohort failed to achieve the minimum recommended PA. Mean ± SD VO was 27.4 ± 6.5 mL/kg fat-free mass/min (18.8 ± 5.0 mL/kg/min).
On average, patients with T2DM who have or are at risk for ASCVD report low levels of PA and have low measured cardiopulmonary fitness. This underscores the importance of continued efforts to close this therapeutic gap.
生活方式干预仍然是 2 型糖尿病(T2DM)管理的基石。然而,该人群对体力活动(PA)建议的依从性及其对心肺适应性的影响描述甚少。我们旨在研究 T2DM 患者人群中对 PA 建议的依从性及其与心肺适应性的关系。
对一项随机临床试验(NCT00424762)的基线数据进行了横断面分析。共招募了 150 名在单家学术医疗中心的门诊接受药物治疗的 T2DM 合并动脉粥样硬化性心血管疾病(ASCVD)或 ASCVD 危险因素的患者。所有患者均进行了分级递增最大运动平板试验,直至力竭,同时进行呼吸气体交换分析以确定 VO。PA 采用结构化的 7 天体力活动回忆访谈进行评估。
参与者的平均年龄 ± 标准差为 54.9 ± 9.0 岁;41%为女性,40%为黑人,21%为西班牙裔。平均 HbA1c 为 7.7 ± 1.8%,平均 BMI 为 34.5 ± 7.2kg/m。72%患有高血压,73%患有高脂血症,35%患有 ASCVD。平均 ± 标准差报告的每日 PA 为 34.3 ± 4 kcal/kg,仅比久坐状态高 7%;队列中有 47%的人未能达到最低推荐 PA。平均 ± 标准差 VO 为 27.4 ± 6.5 mL/kg 去脂体重/min(18.8 ± 5.0 mL/kg/min)。
平均而言,患有或有 ASCVD 风险的 T2DM 患者报告的 PA 水平较低,心肺适应性较低。这突显了继续努力缩小这一治疗差距的重要性。