Fel Solenne, Rochette Emmanuelle, Walther Guillaume, Echaubard Stéphane, Pereira Bruno, Merlin Etienne, Terral Daniel, Duché Pascale
Pédiatrie Générale et Multidisciplinaire, CHU Clermont-Ferrand, Clermont-Ferrand, France.
INSERM, CIC 1405, Unité CRECHE, Université Clermont Auvergne, Clermont-Ferrand, France.
Front Physiol. 2021 Apr 9;12:664211. doi: 10.3389/fphys.2021.664211. eCollection 2021.
We evaluated substrate utilization during submaximal exercise, together with glycemic responses and hormonal counter-regulation to exercise, in children with type 1 diabetes mellitus (T1DM). Twelve pre-pubescent children with T1DM and 12 healthy children were matched by sex and age. Participants completed a submaximal incremental exercise test to determine their fat and carbohydrate oxidation rates by indirect calorimetry. Levels of glycemia, glucagon, cortisol, growth hormone, noradrenaline, adrenaline, and insulin were monitored until 120 min post-exercise. Absolute peak oxygen uptake (VO peak) was significantly lower in the children with T1DM than in the healthy controls (1131.4 ± 102.5 vs. 1383.0 ± 316.6 ml.min, = 0.03). Overall carbohydrate and lipid oxidation rates were the same in the two groups, but for exercise intensities, higher than 50% of VO peak, fat oxidation rate was significantly lower in the children with T1DM. The absolute maximal lipid oxidation rate was significantly lower in the T1DM children (158.1 ± 31.6 vs. 205.4 ± 42.1 mg.min, = 0.005), and they reached a significantly lower exercise power than the healthy controls (26.4 ± 1.2 vs. 35.4 ± 3.3 W, = 0.03). Blood glucose responses to exercise were negatively correlated with pre-exercise blood glucose concentrations ( = -0.67; = 0.03). Metabolic and hormonal responses during sub-maximal exercise are impaired in young children with T1DM.
我们评估了1型糖尿病（T1DM）患儿在次最大运动期间的底物利用情况，以及运动时的血糖反应和激素对抗调节。12名青春期前的T1DM患儿和12名健康儿童按性别和年龄进行匹配。参与者完成了一次次最大递增运动测试，通过间接量热法测定他们的脂肪和碳水化合物氧化率。监测血糖、胰高血糖素、皮质醇、生长激素、去甲肾上腺素、肾上腺素和胰岛素水平直至运动后120分钟。T1DM患儿的绝对峰值摄氧量（VO₂峰值）显著低于健康对照组（1131.4±102.5 vs. 1383.0±316.6 ml·min，P = 0.03）。两组的总体碳水化合物和脂质氧化率相同，但对于高于VO₂峰值50%的运动强度，T1DM患儿的脂肪氧化率显著较低。T1DM患儿的绝对最大脂质氧化率显著较低（158.1±31.6 vs. 205.4±42.1 mg·min，P = 0.005），并且他们达到的运动功率显著低于健康对照组（26.4±1.2 vs. 35.4±3.3 W，P = 0.03）。运动时的血糖反应与运动前血糖浓度呈负相关（r = -0.67；P = 0.03）。T1DM幼儿在次最大运动期间的代谢和激素反应受损。
