Morris Zoe, Camarillo Nathan, Hasni Sarfaraz, Keyser Randall E, Chan Leighton, Chin Lisa Mk
Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Tampa General Hospital, Tampa, FL, USA.
Lupus. 2025 Aug;34(9):922-931. doi: 10.1177/09612033251349464. Epub 2025 Jun 12.
Fatigue among females with systemic lupus erythematosus (SLE) is commonly reported as the most debilitating symptom. Slower oxygen uptake (VO) on-kinetics have been observed among females with SLE, when compared to healthy control individuals. Aerobic exercise training may improve VO on-kinetics, however, this has not been examined in the SLE population.ObjectiveTo characterize VO on-kinetics in SLE and examine changes after 12 weeks of aerobic exercise training (AET).MethodsFemales ( = 16; 42 ± 10 years) with SLE (SELENA-SLEDAI ≤ 4) completed a cardiopulmonary exercise test (CPET) and a constant work rate test (CWRT), before and after participation in supervised vigorous treadmill AET for 12 weeks. Pulmonary gas exchange, heart rate (HR) and deoxygenation ([HHb]) of the right gastrocnemius muscle were also measured during the CWRT. Model fits for VO, HR and [HHb] were performed, and a ratio of the increase in [HHb] and VO were examined in a subset of participants ( = 10). On-kinetic responses of all variables and the [HHb]/VO ratio were analyzed before and after AET using paired sample t-tests or Wilcoxon signed-rank tests. Spearman's rank correlations were used to examine the relationships of VO on-kinetics and peak CPET variables.ResultsVO on-kinetics was faster (mean difference [95% CI], -value: -12.0 s [-18.1 to -6.0], < .001) following AET, and the VO time constant post-AET was moderate and indirectly related to cardiorespiratory fitness outcomes for peak VO ( = -0.562, = .024) and peak work rate ( = -0.535, = .033). The HR on-kinetics was also faster following AET (median difference [95% CI], -value: -6.7 s [-30.8 to -1.2], = .022), however a change in the [HHb] time course was unlikely (median difference [95% CI], -value: -1.1 s [-3.6 to 23.5], = .508).ConclusionFollowing supervised exercise training, females with SLE demonstrated faster VO on-kinetics, which were also related to cardiorespiratory fitness. The faster VO on-kinetics with exercise training was also accompanied by faster HR on-kinetics, suggesting central circulatory adaptation occurring in these females with SLE.
系统性红斑狼疮(SLE)女性患者的疲劳通常被认为是最使人衰弱的症状。与健康对照个体相比,已观察到SLE女性患者的氧摄取(VO)动力学较慢。有氧运动训练可能会改善VO动力学,然而,尚未在SLE人群中对此进行研究。
目的
描述SLE患者的VO动力学特征,并研究有氧运动训练(AET)12周后的变化。
方法
16名(年龄42±10岁)SLE(SELENA-SLEDAI≤4)女性患者在参加12周有监督的高强度跑步机AET前后,完成了心肺运动试验(CPET)和恒定工作率试验(CWRT)。在CWRT期间,还测量了右腓肠肌的肺气体交换、心率(HR)和脱氧([HHb])情况。对VO、HR和[HHb]进行模型拟合,并在一部分参与者(n = 10)中检查[HHb]和VO增加的比率。使用配对样本t检验或Wilcoxon符号秩检验分析AET前后所有变量的动力学反应和[HHb]/VO比率。使用Spearman秩相关分析VO动力学与CPET峰值变量之间的关系。
结果
AET后VO动力学更快(平均差[95%CI],p值:-12.0秒[-18.1至-6.0],p <.001),AET后的VO时间常数适中,且与VO峰值(r = -0.562,p = .024)和峰值工作率(r = -0.535,p = .033)的心肺适能结果间接相关。AET后HR动力学也更快(中位数差[95%CI],p值:-6.7秒[-30.8至-1.2],p = .022),然而,[HHb]时间进程不太可能发生变化(中位数差[95%CI],p值:-1.1秒[-3.6至23.5],p = .508)。
结论
在有监督的运动训练后,SLE女性患者表现出更快的VO动力学,这也与心肺适能相关。运动训练带来的更快的VO动力学还伴随着更快的HR动力学,表明这些SLE女性患者发生了中枢循环适应。