Radtke Thomas, Kriemler Susi, Stein Lothar, Karila Chantal, Urquhart Don S, Orenstein David M, Lands Larry C, Schindler Christian, Eber Ernst, Haile Sarah R, Hebestreit Helge
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
J Cyst Fibros. 2023 Jan;22(1):31-38. doi: 10.1016/j.jcf.2022.06.012. Epub 2022 Jul 6.
Previous studies have reported differences in aerobic exercise capacity, expressed as peak oxygen uptake (VO), between people with and without cystic fibrosis (CF) related diabetes (CFRD). However, none of the studies controlled for the potential influence of physical activity on VO. We investigated associations between CFRD and VO following rigorous control for confounders including objectively measured physical activity.
Baseline data from the international multicenter trial ACTIVATE-CF with participants ≥12 years performing up to 4 h per week of vigorous physical activity were used for this project. Multivariable models were computed to study associations between CFRD and VO (mL.min) adjusting for a set of pre-defined covariates: age, sex, weight, forced expiratory volume in 1 s (FEV), breathing reserve index, Pseudomonas aeruginosa infection, and physical activity (aerobic step counts from pedometry). Variables were selected based on their potential confounding effect on the association between VO and CFRD.
Among 117 randomized individuals, 103 (52% female) had a maximal exercise test and were included in the analysis. Participants with (n = 19) and without (n = 84) CFRD did not differ in FEV, physical activity, nutritional status, and other clinical characteristics. There were also no differences in VO (mL.min or mL.kg.min or% predicted). In the final multivariable model, all pre-defined covariates were significant predictors of VO (mL.min), however CFRD [coefficient 82.1, 95% CI -69.5 to 233.8, p = 0.28] was not.
This study suggests no meaningful differences in VO between people with and without CFRD given comparable levels of physical activity.
既往研究报道了患有和未患有囊性纤维化（CF）相关糖尿病（CFRD）的人群在有氧运动能力方面存在差异，以峰值摄氧量（VO）表示。然而，这些研究均未控制体力活动对VO的潜在影响。我们在严格控制包括客观测量的体力活动在内的混杂因素后，研究了CFRD与VO之间的关联。
本项目使用了国际多中心试验ACTIVATE-CF的基线数据，参与者年龄≥12岁，每周进行高达4小时的剧烈体力活动。计算多变量模型以研究CFRD与VO（毫升/分钟）之间的关联，并对一组预先定义的协变量进行调整：年龄、性别、体重、第1秒用力呼气量（FEV）、呼吸储备指数、铜绿假单胞菌感染和体力活动（计步器测得的有氧步数）。根据变量对VO与CFRD之间关联的潜在混杂效应来选择变量。
在117名随机分组的个体中，103名（52%为女性）进行了最大运动测试并纳入分析。患有（n = 19）和未患有（n = 84）CFRD的参与者在FEV、体力活动、营养状况和其他临床特征方面没有差异。VO（毫升/分钟或毫升/千克/分钟或预测百分比）也没有差异。在最终的多变量模型中，所有预先定义的协变量都是VO（毫升/分钟）的显著预测因素，然而CFRD[系数82.1，95%置信区间-69.5至233.8，p = 0.28]不是。
本研究表明，在体力活动水平相当的情况下，患有和未患有CFRD的人群在VO方面没有有意义的差异。
