Cardiorespiratory capacity is associated with favourable cardiovascular risk profile in patients with Type 2 diabetes

Kadoglou, Nikolaos P.E.; Iliadis, Fotios; Angelopoulou, Nikoleta; Sailer, Nikolaos; Fotiadis, Grigorios; Voliotis, Kleon; Vitta, Ioulia; Liapis, Christos D.; Alevizos, Miltiadis

doi:10.1016/j.jdiacomp.2007.12.008

« Previous Next »Journal of Diabetes and Its Complications
Volume 23, Issue 3 , Pages 160-166, May 2009

Cardiorespiratory capacity is associated with favourable cardiovascular risk profile in patients with Type 2 diabetes☆

Nikolaos P.E. Kadoglou
- 1st Department of Internal Medicine, “Hippokratio” General Hospital of Thessaloniki, Greece
- Corresponding author. 124 Vosporou str, 54454 Thessaloniki, Greece. Tel.: +30 2310905178; fax: +30 2310905178.
Fotios Iliadis
- 1st Propedeutic Department of Internal Medicine, AHEPA University Hospital of Thessaloniki, Greece
Nikoleta Angelopoulou
- Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Greece
Nikolaos Sailer
- 1st Department of Internal Medicine, “Hippokratio” General Hospital of Thessaloniki, Greece
Grigorios Fotiadis
- 1st Department of Internal Medicine, “Hippokratio” General Hospital of Thessaloniki, Greece
Kleon Voliotis
- 1st Department of Internal Medicine, “Hippokratio” General Hospital of Thessaloniki, Greece
Ioulia Vitta
- 1st Department of Internal Medicine, “Hippokratio” General Hospital of Thessaloniki, Greece
Christos D. Liapis
- Department of Vascular Surgery, Medical School, University of Athens, Greece
Miltiadis Alevizos
- 1st Propedeutic Department of Internal Medicine, AHEPA University Hospital of Thessaloniki, Greece

Received 7 August 2007; received in revised form 14 December 2007; accepted 27 December 2007. published online 14 March 2008.

Abstract

Objective

The aim of this study was to examine the interaction between cardiorespiratory capacity and cardiovascular risk factors in patients with Type 2 diabetes mellitus (T2DM).

Research Design/Methods

A total of 92 patients with T2DM (40 men, 52 women) performed a symptom-limited exercise test on ergocycle, with continuous gas exchange measurement. All patients were overweight or obese (body mass index >25 kg/m²), with poor glycemic control (hemoglobin A_1c >7%), but free from overt diabetic vascular complications. Anthropometric parameters, blood pressure (BP), cardiorespiratory fitness, glycemic and lipid profile, fibrinogen, plasminogen activator inhibitor-1, high-sensitivity C-reactive protein (hsCRP), insulin resistance, and 24-h urinary albumin excretion (UAE) were measured. Based on the median V̇o₂ peak value, participants were placed into low fitness (LF, n=46) or moderate fitness group (MF, n=46).

Results

In univariate analysis, exercise capacity correlated with systolic (r=−0.349) and diastolic BP (r=−0.441), waist circumference (r=−0.345), total cholesterol (r=−0.348), high-density lipoprotein (HDL) (r=0.362), UAE (r=−0.486), homeostasis model assessment (HOMA-IR) (r=−0.467), uric acid (r=−0.316), and hsCRP (r=−0.217, only in women subgroup) (P<.05). With the exception of the latter three variables, the above associations remained significant after controlling for age and sex in multiple regression analysis (P<.05). Compared to LF group, patients in MF group showed significantly higher levels of HDL and lower levels of BP, waist circumference, hsCRP, and HOMA-IR (P<.05). In addition to this, UAE tended to be lower in fit patients (P=.054).

Conclusions

Low cardiorespiratory fitness seems to be independently associated with most traditional and emerging cardiovascular risk factors in patients with T2DM. Even a moderate increase of cardiorespiratory fitness exerts beneficial effects on cardiovascular risk profile.

Keywords: Diabetes mellitus, Exercise capacity, Cardiovascular risk factors, PAI-1, Uric acid, Vo₂peak