The implications of dysglycaemia on aerobic exercise and ventilatory function in cystic fibrosis
The implications of dysglycaemia on aerobic exercise and ventilatory function in cystic fibrosis
BACKGROUND: The development of cystic fibrosis (CF)-related diabetes (CFRD) in paediatric groups is associated with a reduced aerobic fitness. However, this has yet to be investigated in adults with more severe lung disease.
METHODS: Cardiopulmonary exercise and glycaemic control tests were retrospectively analysed in 46 adults with CF (age: 26.9 y [range: 16.3-66.5 y]; forced expiratory volume in 1s: 65.3% [range: 26.8-105.7%]; 26 males), diagnosed with CFRD (n = 19), impaired glucose tolerance (IGT; n = 8) or normal glucose tolerance (NGT; n = 19).
RESULTS: Maximal oxygen uptake (V˙O2max) was reduced in adults with IGT and CFRD compared to their age- and gender-matched counterparts with NGT (p < 0.05); however, there was no difference when lung function was included as a covariate (all p > 0.05). V˙O2max was greater in adults who experienced post-reactive hypoglycaemia vs. NGT without hypoglycaemia (p < 0.05). The frequency of ventilatory limitation (84%, 63% and 37%, respectively; p < 0.05) but not ventilation-perfusion mismatch (42%, 38% and 16%, respectively; p > 0.05), was greater with CFRD and IGT vs. NGT. There was also no difference in arterial oxygen saturation changes between groups (p > 0.05). Gender and body mass index were significant predictors of V˙O2max (adjusted R2 = 0.37, p < 0.01), but glycaemic control did not explain additional variance (p > 0.05).
CONCLUSIONS: Adults with CF-related dysglycaemia had a reduced V˙O2max compared to age- and gender-matched counterparts, due to a greater degree of CF lung disease in these populations.
Adult, Cardiorespiratory Fitness/physiology, Correlation of Data, Cystic Fibrosis/diagnosis, Diabetes Mellitus/blood, Exercise/physiology, Exercise Test/methods, Female, Forced Expiratory Volume, Glucose Intolerance/diagnosis, Glucose Tolerance Test/methods, Humans, Male, Oxygen Consumption, Respiratory Function Tests/methods, Retrospective Studies, Severity of Illness Index, United Kingdom/epidemiology
427-433
Causer, Adam J
17d4182a-d52f-4b92-89fc-99cec813e98d
Shute, Janis K
a5eef853-50ae-4abf-9e34-1c873601437f
Cummings, Michael H
49e830d1-aa87-4dd0-8258-35c3d5ac9c35
Shepherd, Anthony I
f7073e22-cda6-4816-a4b4-f6246e1aa42e
Wallbanks, Samuel R
153b083d-fb87-45ad-b571-517f738a2c6c
Allenby, Mark I
f04ca0f2-e772-4fc2-925b-9fae103db2f6
Arregui-Fresneda, Irantzu
437ca897-6ae3-4a6a-8908-a1a14d203c76
Bright, Victoria
b9927700-00e1-489f-a671-27fa7d3d2995
Carroll, Mary P
b836d262-6b07-4006-9c81-26653a26588b
Connett, Gary
55d5676c-90d8-46bf-a508-62eded276516
Daniels, Thomas
d635a2fb-96a1-46ec-8cdf-8eb44a4bd0f5
Meredith, Tom
b7f0ef50-7375-4880-8f84-99aa9332238c
Saynor, Zoe L
ffd5d87a-2cfd-4c83-8f3c-4ef0144c8db8
2 November 2019
Causer, Adam J
17d4182a-d52f-4b92-89fc-99cec813e98d
Shute, Janis K
a5eef853-50ae-4abf-9e34-1c873601437f
Cummings, Michael H
49e830d1-aa87-4dd0-8258-35c3d5ac9c35
Shepherd, Anthony I
f7073e22-cda6-4816-a4b4-f6246e1aa42e
Wallbanks, Samuel R
153b083d-fb87-45ad-b571-517f738a2c6c
Allenby, Mark I
f04ca0f2-e772-4fc2-925b-9fae103db2f6
Arregui-Fresneda, Irantzu
437ca897-6ae3-4a6a-8908-a1a14d203c76
Bright, Victoria
b9927700-00e1-489f-a671-27fa7d3d2995
Carroll, Mary P
b836d262-6b07-4006-9c81-26653a26588b
Connett, Gary
55d5676c-90d8-46bf-a508-62eded276516
Daniels, Thomas
d635a2fb-96a1-46ec-8cdf-8eb44a4bd0f5
Meredith, Tom
b7f0ef50-7375-4880-8f84-99aa9332238c
Saynor, Zoe L
ffd5d87a-2cfd-4c83-8f3c-4ef0144c8db8
Causer, Adam J, Shute, Janis K, Cummings, Michael H, Shepherd, Anthony I, Wallbanks, Samuel R, Allenby, Mark I, Arregui-Fresneda, Irantzu, Bright, Victoria, Carroll, Mary P, Connett, Gary, Daniels, Thomas, Meredith, Tom and Saynor, Zoe L
(2019)
The implications of dysglycaemia on aerobic exercise and ventilatory function in cystic fibrosis.
Journal of Cystic Fibrosis, 19 (3), .
(doi:10.1016/j.jcf.2019.09.014).
Abstract
BACKGROUND: The development of cystic fibrosis (CF)-related diabetes (CFRD) in paediatric groups is associated with a reduced aerobic fitness. However, this has yet to be investigated in adults with more severe lung disease.
METHODS: Cardiopulmonary exercise and glycaemic control tests were retrospectively analysed in 46 adults with CF (age: 26.9 y [range: 16.3-66.5 y]; forced expiratory volume in 1s: 65.3% [range: 26.8-105.7%]; 26 males), diagnosed with CFRD (n = 19), impaired glucose tolerance (IGT; n = 8) or normal glucose tolerance (NGT; n = 19).
RESULTS: Maximal oxygen uptake (V˙O2max) was reduced in adults with IGT and CFRD compared to their age- and gender-matched counterparts with NGT (p < 0.05); however, there was no difference when lung function was included as a covariate (all p > 0.05). V˙O2max was greater in adults who experienced post-reactive hypoglycaemia vs. NGT without hypoglycaemia (p < 0.05). The frequency of ventilatory limitation (84%, 63% and 37%, respectively; p < 0.05) but not ventilation-perfusion mismatch (42%, 38% and 16%, respectively; p > 0.05), was greater with CFRD and IGT vs. NGT. There was also no difference in arterial oxygen saturation changes between groups (p > 0.05). Gender and body mass index were significant predictors of V˙O2max (adjusted R2 = 0.37, p < 0.01), but glycaemic control did not explain additional variance (p > 0.05).
CONCLUSIONS: Adults with CF-related dysglycaemia had a reduced V˙O2max compared to age- and gender-matched counterparts, due to a greater degree of CF lung disease in these populations.
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Published date: 2 November 2019
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Crown Copyright © 2019. Published by Elsevier B.V. All rights reserved.
Keywords:
Adult, Cardiorespiratory Fitness/physiology, Correlation of Data, Cystic Fibrosis/diagnosis, Diabetes Mellitus/blood, Exercise/physiology, Exercise Test/methods, Female, Forced Expiratory Volume, Glucose Intolerance/diagnosis, Glucose Tolerance Test/methods, Humans, Male, Oxygen Consumption, Respiratory Function Tests/methods, Retrospective Studies, Severity of Illness Index, United Kingdom/epidemiology
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Local EPrints ID: 488036
URI: http://eprints.soton.ac.uk/id/eprint/488036
ISSN: 1569-1993
PURE UUID: a5947c11-3c66-422d-a368-48519a96f996
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Date deposited: 12 Mar 2024 18:23
Last modified: 18 Mar 2024 03:46
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Author:
Adam J Causer
Author:
Janis K Shute
Author:
Michael H Cummings
Author:
Anthony I Shepherd
Author:
Samuel R Wallbanks
Author:
Mark I Allenby
Author:
Irantzu Arregui-Fresneda
Author:
Victoria Bright
Author:
Mary P Carroll
Author:
Gary Connett
Author:
Thomas Daniels
Author:
Tom Meredith
Author:
Zoe L Saynor
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