Distinct effects of type 2 diabetes and obesity on cardiopulmonary performance
Authors' conclusion
T2D is an independent negative determinant of VO2peak whose effect is additive to other pathophysiological determinants of oxygen uptake, including BMI.
Study context
- Population
- Patients at high/moderate cardiovascular risk, with or without T2D, free from cardiopulmonary disease, undergoing spirometry and combined echocardiography-cardiopulmonary exercise test
- Participants
- 109 vs 97
- Comparison
- T2D vs controls
- T2Dn = 109
- Controlsn = 97reference
- Outcome
- VO2peak (oxygen uptake at peak exercise), normalized for fat-free mass in multivariable models
Methodological detailsmultivariable regression analysis
- Multivariable regression analysis
Main finding
VO2peak
Adjusted reduction in VO2peak
1.0 ml/min/kgFFM
CI −1.7/−0.3
P = 0.0089
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
BMI · higher with T2D
P = 0.0003
Body mass index (BMI)
- Comparable fat-free mass (FFM) between groups
Effect of BMI on VO2peakFFM per unit increase
- Adjusted effect of BMI per unit increase, ml/min/kgFFM (p = .06); largely explained by chronotropic incompetence, reduced peripheral oxygen extraction, impaired systolic reserve and ventilatory (in)efficiency
- −0.2 (−0.3/0.1)
Subclinical cardiovascular dysfunction in T2D
- Concentric left ventricular remodelling, autonomic dysfunction, systolic dysfunction and reduced systolic reserve observed in T2D
Original publication
Distinct effects of type 2 diabetes and obesity on cardiopulmonary performance. Diabetes Obes Metab. Published 12 October 2023. doi:10.
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