Mikeš Ondřej, Prázný Martin, Šoupal Jan, Marek Josef, Matoulek Martin, Tuka Vladimír
Third Department of Internal Medicine, First Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic.
Second Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic.
Sci Rep. 2025 Aug 13;15(1):29633. doi: 10.1038/s41598-025-15513-8.
Type 1 diabetes mellitus (T1DM) is a chronic disease that usually manifests at a younger age and is associated with higher morbidity and mortality compared to the general population. The objective of this study was to assess the blood pressure response to exercise in patients with T1DM with varying durations of diabetes and with respect to the determinants of systolic blood pressure (SBP) and diastolic blood pressure (DBP) during the exercise stress test. This cross-sectional exploratory study included 52 patients (35 with T1DM aged < 35 years and 17 aged > 35 years) and 25 control subjects. All participants were untrained and underwent a cardiopulmonary exercise stress test using a cycle ergometer and their BP was measured manually. Compared to control subjects, both younger and older patients with T1DM had higher SBP and DBP at submaximal exercise load 0,5 W/kg (SBP 124 ± 18; 142 ± 17; 146 ± 19 mmHg, p = 0.0004, respectively, and DBP 75 ± 10; 84 ± 7; 82 ± 7 mmHg, p = 0.0015, respectively), and at peak exercise (SBP 170 ± 24; 188 ± 26; 192 ± 23 mmHg, p = 0.0006, respectively. BP during exercise in T1DM patients in multivariate model was influenced by resting SBP, and diabetes duration. Patients with T1DM exhibited impaired BP control during exercise, which may serve as an early marker of heightened cardiovascular risk.
1型糖尿病(T1DM)是一种慢性病,通常在较年轻时发病,与普通人群相比,其发病率和死亡率更高。本研究的目的是评估不同糖尿病病程的T1DM患者在运动应激试验期间对运动的血压反应,以及收缩压(SBP)和舒张压(DBP)的决定因素。这项横断面探索性研究纳入了52例患者(35例年龄<35岁的T1DM患者和17例年龄>35岁的患者)以及25名对照者。所有参与者均未经训练,使用自行车测力计进行心肺运动应激试验,并手动测量其血压。与对照者相比,年轻和老年T1DM患者在次最大运动负荷0.5W/kg时的SBP和DBP均较高(SBP分别为124±18、142±17、146±19mmHg,p = 0.0004;DBP分别为75±10、84±7、82±7mmHg,p = 0.0015),在运动峰值时也是如此(SBP分别为170±24、188±26、192±23mmHg,p = 0.0006)。在多变量模型中,T1DM患者运动期间的血压受静息SBP和糖尿病病程的影响。T1DM患者在运动期间表现出血压控制受损,这可能是心血管风险增加的早期标志物。