Schwaab Bernhard, Windmöller Mirca, König Inke R, Schütt Morten
Curschmann Klinik, Rehabilitation Clinic for Cardiology, Angiology and Diabetes, 23669 Timmendorfer Strand, Germany.
Institute of Medical Biometry and Statistics, University Hospital Schleswig Holstein, Campus Lübeck, University of Lübeck, 23562 Lübeck, Germany.
J Clin Med. 2020 Aug 27;9(9):2773. doi: 10.3390/jcm9092773.
(1) Background: Physical activity is recommended in patients with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) to reduce hyperglycemia and cardiovascular risk. Effective aerobic exercise intensity, however, is not well defined. (2) Methods: 60 consecutive patients performed cardiopulmonary exercise testing (CPX) of 30 min duration targeting a respiratory exchange ratio (RER) between 0.85 and 0.95, being strictly aerobic. Plasma glucose (PG) was measured before and after CPX as well as one and two h after exercise. Maximum exercise intensity was evaluated using a standard bicycle exercise test. (3) Results: 50 patients completed the protocol (62 ± 10 years, BMI (body mass index) 30.5 ± 4.9 kg/m, HbA1c (glycated haemoglobin) 6.9 ± 0.8%, left ventricular ejection fraction 55 ± 8%). Aerobic exercise capacity averaged at 32 ± 21 Watt (range 4-76 Watt) representing 29.8% of the maximum exercise intensity reached. PG before and after CPX was 9.3 ± 2.2 and 7.6 ± 1.7 mmol/L, respectively ( < 0.0001). PG was further decreased significantly at one and two h after exercise to 7.5 ± 1.6 mmol/L and 6.0 ± 1.0 mmol/L, respectively ( < 0.0001 for both as compared to PG before CPX). (4) Conclusions: Aerobic exercise capacity is very low in patients with CAD and T2DM. Exercise at aerobic intensity allowed for significant reduction of plasma glucose. Individual and effective aerobic exercise prescription is possible by CPX.
(1) 背景：对于2型糖尿病（T2DM）和冠状动脉疾病（CAD）患者，建议进行体育活动以降低高血糖和心血管风险。然而，有效的有氧运动强度尚未明确界定。(2) 方法：60例连续患者进行了30分钟的心肺运动试验（CPX），目标是呼吸交换率（RER）在0.85至0.95之间，严格为有氧运动。在CPX前后以及运动后1小时和2小时测量血浆葡萄糖（PG）。使用标准自行车运动试验评估最大运动强度。(3) 结果：50例患者完成了方案（年龄62±10岁，体重指数（BMI）30.5±4.9 kg/m²，糖化血红蛋白（HbA1c）6.9±0.8%，左心室射血分数55±8%）。有氧运动能力平均为32±21瓦（范围4 - 76瓦），占达到的最大运动强度的29.8%。CPX前后的PG分别为9.3±2.2和7.6±1.7 mmol/L（P<0.0001）。运动后1小时和2小时PG进一步显著降低，分别降至7.5±1.6 mmol/L和6.0±1.0 mmol/L（与CPX前的PG相比，两者P均<0.0001）。(4) 结论：CAD和T2DM患者的有氧运动能力非常低。有氧运动强度的运动可显著降低血浆葡萄糖。通过CPX可以制定个性化且有效的有氧运动处方。
