Flotyńska Justyna, Naskręt Dariusz, Niedźwiecki Paweł, Grzelka-Woźniak Agata, Pypeć Aleksandra, Kaczmarek Anita, Cieluch Aleksandra, Zozulińska-Ziółkiewicz Dorota, Uruska Aleksandra
Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Poznan, Poland.
Doctoral School, Poznan University of Medical Sciences, Collegium Stomatologicum, Poznan, Poland.
Clin Med Insights Endocrinol Diabetes. 2024 Apr 15;17:11795514241244872. doi: 10.1177/11795514241244872. eCollection 2024.
An essential process affecting the course of type 1 diabetes (DM1) is the appearance and duration of clinical remission. One of the most important factors promoting the occurrence of remission is physical activity, due to increased activity of antioxidants, reduces insulin resistance and improves glucose transport. Maximal oxygen capacity (VOmax) is an objective measure of the body's aerobic capacity. To assess VOmax, oxygen uptake should be measured directly during the exercise test. The aim of the study was to evaluate the physical capacity in adults with DM1 and its relationship with the occurrence of partial clinical remission (pCR) during 2 years follow-up.
The pCR was assessed by the following mathematical formula: A1c (%) + [4 × insulin dose (U/kg/d)]. The result ⩽9 indicates pCR. VOmax was assessed between 6th and 24th month of diabetes duration using an ergospirometer (COSMED K5 System), during an exercise test carried out on a cycloergometer (RAMP incremental exercise test).
The study group consisted of 32 adults with DM1. People with pCR were proved to have higher VOmax level [36.0 (33.0-41.5) vs 30.9 (26.5-34.4) ml/min/kg, = .009. Univariate and multivariate regression confirmed a significant association between VOmax and presence of pCR [AOR 1.26 (1.05-1.52), = .015]. Duration of remission was longer among group with higher VOmax results [15 (9-24) vs 9 (0-12) months, = .043]. The positive relationship was observed between diabetes duration and VOmax (rs = 0.484, = .005). Multivariate linear regression confirms a significant association between remission duration and VOmax (ml/min/kg) (β = 0.595, = .002).
The higher VOmax, the better chance of partial clinical remission at 2 years of DM1 and longer duration of remission.
影响1型糖尿病（DM1）病程的一个重要过程是临床缓解的出现及其持续时间。促进缓解发生的最重要因素之一是体育活动，因为抗氧化剂活性增加，可降低胰岛素抵抗并改善葡萄糖转运。最大摄氧量（VOmax）是身体有氧能力的客观指标。为评估VOmax，应在运动测试期间直接测量摄氧量。本研究的目的是评估DM1成年患者的身体能力及其与2年随访期间部分临床缓解（pCR）发生的关系。
通过以下数学公式评估pCR：糖化血红蛋白（A1c）（%）+[4×胰岛素剂量（U/kg/d）]。结果≤9表示pCR。在糖尿病病程的第6至24个月期间，使用运动心肺功能测试仪（COSMED K5系统），在卧式测力计上进行递增运动测试（RAMP递增运动测试）时评估VOmax。
研究组由32名DM1成年患者组成。事实证明，发生pCR的患者VOmax水平更高[36.0（33.）-41.5）对30.9（26.5-34.4）ml/min/kg，P=.009]。单因素和多因素回归证实VOmax与pCR的存在之间存在显著关联[调整后比值比（AOR）1.26（1.05-1.52），P=.015]。VOmax结果较高的组缓解持续时间更长[15（9-24）对9（0-12）个月，P=.043]。观察到糖尿病病程与VOmax之间存在正相关（斯皮尔曼相关系数rs=0.484，P=.005）。多因素线性回归证实缓解持续时间与VOmax（ml/min/kg）之间存在显著关联（β=0.595，P=.002）。
VOmax越高，DM1患者在2年时出现部分临床缓解的机会越大，缓解持续时间越长。
