The metabolome as a diagnostic for maximal aerobic capacity during exercise in type 1 diabetes
Authors' conclusion
The serum metabolome distinguishes high and low maximal aerobic capacity and has diagnostic potential for facilitating personalised medicine approaches to manage aerobic exercise and fitness in type 1 diabetes.
Study context
- Population
- People with T1D (≥3 years duration) and controls not differing in age or sex; T1D categorised by peak stimulated C-peptide as undetectable (<3 pmol/l), low (3–200 pmol/l) or high (>200 pmol/l)
- Participants
- 30 vs 30
- Comparison
- T1D vs control participants during aerobic exercise
- T1Dn = 30
- Controln = 30reference
- Outcome
- Metabolic response to aerobic exercise and metabolomic markers of maximal aerobic capacity (V̇O2peak)
Methodological detailstargeted serum metabolomics, case-control, 45 min incline treadmill walking (60% V̇O2peak); venous blood pre-exercise, immediately post exercise and after 60 min recovery
- Targeted serum metabolomics
- Case-control
- 45 min incline treadmill walking (60% V̇O2peak); venous blood pre-exercise, immediately post exercise and after 60 min recovery
Main finding
As reported in the abstract
- V̇O2peak inversely correlated with HbA1c in T1D
- r2=0.17, p=0.024
- Higher resting serum malic acid differentiated T1D
- fold change 1.4, p=0.001
- Higher resting serum lactate differentiated T1D
- fold change 1.22, p=1.23×10-5
- Higher serum acylcarnitines (AC) C14:1 unique to exercise response in T1D
- F value=12.25, p=0.001345
- Higher serum AC C12 unique to exercise response in T1D
- F value=11.055, p=0.0018
- C-peptide status differentially affected serum AC responses during exercise (AC C18:1)
- leverage 0.066; squared prediction error 3.07
- Resting serum malic acid/pyruvate ratio diagnostic for V̇O2peak in T1D (ROC AUC)
- 0.867 [95% CI 0.716, 0.956]
Further findings
Maximal aerobic capacity (V̇O2peak)
- V̇O2peak did not differ between control and T1D
Original publication
The metabolome as a diagnostic for maximal aerobic capacity during exercise in type 1 diabetes. Diabetologia. Published 25 April 2024. doi:10.
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