Differential Patterns of Impaired Cardiorespiratory Fitness and Cardiac Autonomic Dysfunction in Recently Diagnosed Type 1 and Type 2 Diabetes

Röhling, Martin; Strom, Alexander; Bönhof, Gidon J.; Püttgen, Sonja; Bódis, Kálmán; Müssig, Karsten; Szendrödi, Julia; Markgraf, Daniel F.; Lehr, Stefan; Roden, Michael; Ziegler, Dan

doi:10.2337/dc16-1898

Cited by 29 publications

(24 citation statements)

References 43 publications

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“…In the present study, after adjusting for CRF, it was observed that total sedentary time was only associated with HbA1c, whereas BST had favorable associations with HOMA-IR, Matsuda index, and fasting glucose. Thus, as previously shown (Ekblom-Bak et al, 2016; Rohling et al, 2016), CRF can neutralize most of the associations for total sedentary time with glycemic outcomes, and this may be explained by the association between total sedentary time and CRF itself (Krogh-Madsen et al, 2010). …”

Section: Discussionmentioning

confidence: 52%

“…Alongside with these results, replacing 30 min of sedentary time with LIPA provided higher benefits in metabolic profile in participants with lower CRF when compared with those with normal to high CRF levels (Ekblom-Bak et al, 2016), suggesting that the associations between sedentary pursuits and metabolic outcomes may be moderated by CRF. There is a lack of studies that analyzed the associations for sedentary time and respective patterns with glycemic indicators while adjusting for CRF (Ekblom-Bak et al, 2016; Rohling et al, 2016). In the present study, after adjusting for CRF, it was observed that total sedentary time was only associated with HbA1c, whereas BST had favorable associations with HOMA-IR, Matsuda index, and fasting glucose.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, patients with lower fitness and high fasting glucose levels benefited more from replacing the same amount of sedentary time with LIPA and MVPA, compared with participants with normal to high cardiorespiratory fitness levels (CRF) (Ekblom-Bak et al, 2016). Additionally, CRF seems to be positively associated with glycemic control (Rohling et al, 2016), and may be an important mediator in the relationship between sedentary behavior and MVPA with metabolic outcomes (Rohling et al, 2016). …”

Section: Introductionmentioning

confidence: 99%

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Sedentary Patterns, Physical Activity, and Cardiorespiratory Fitness in Association to Glycemic Control in Type 2 Diabetes Patients

et al. 2017

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Background: Sedentary behavior has been considered an independent risk factor for type-2 diabetes (T2D), with a negative impact on several physiological outcomes, whereas breaks in sedentary time (BST) have been proposed as a viable solution to mitigate some of these effects. However, little is known about the independent associations of sedentary pursuits, physical activity, and cardiorespiratory fitness (CRF) variables with glycemic control. We investigated the independent associations of total sedentary time, BST, moderate-to-vigorous physical activity (MVPA), and CRF with glycemic outcomes in patients with T2D.Methods: Total sedentary time, BST, and MVPA were assessed in 66 participants (29 women) with T2D, using accelerometry. Glucose and insulin were measured during a mixed meal tolerance test, with the respective calculations of HOMA-IR and Matsuda index. Glycated hemoglobin (HbA1c) was also analyzed. CRF was measured in a maximal treadmill test with breath-by-breath gases analysis. Multiple regressions were used for data analysis.Results: Regardless of CRF, total sedentary time was positively associated with HbA1c (β = 0.25, p = 0.044). Adjusting for MVPA, total sedentary time was related to fasting glucose (β = 0.32, p = 0.037). No associations between total sedentary time and the remaining glycemic outcomes, after adjusting for MVPA. BST had favorable associations with HOMA-IR (β = −0.28, p = 0.047) and fasting glucose (β = −0.25, p = 0.046), when adjusted for MVPA, and with HOMA-IR (β = −0.25, p = 0.036), Matsuda index (β = 0.26, p = 0.036), and fasting glucose (β = −0.22, p = 0.038), following adjustment for CRF. When adjusting for total sedentary time, only CRF yielded favorable associations with HOMA-IR (β = −0.29, p = 0.039), fasting glucose (β = −0.32, p = 0.012), and glucose at 120-min (β = −0.26, p = 0.035), and no associations were found for MVPA with none of the metabolic outcomes.Conclusion: The results from this study suggest that sedentary time and patterns are relevant for the glycemic control in patients with T2D. Still, MVPA and CRF counteracted most of the associations for total sedentary time but not for the BST. MVPA was not associated with metabolic outcomes, and CRF lost some of the associations with glycemic indicators when adjusted for total sedentary time. Future interventions aiming to control/improve T2D must consider reducing and breaking up sedentary time as a viable strategy to improve glycemic control.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sedentary Patterns, Physical Activity, and Cardiorespiratory Fitness in Association to Glycemic Control in Type 2 Diabetes Patients

et al. 2017

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“…There appears to be a diabetes specific effect on resting HRV, as reductions in resting HRV metrics are apparent in newly diagnosed T1D without a decline in cardiorespiratory fitness (Röhling et al. ). Nevertheless, some of the controversy regarding frequency‐domain HRV analysis warrants consideration.…”

Section: Discussionmentioning

confidence: 99%

Resting heart rate variability and exercise capacity in Type 1 diabetes

et al. 2017

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People with type 1 diabetes (T1D) have lower exercise capacity (V̇O2max) than their age‐matched nondiabetic counterparts (CON), which might be related to cardiac autonomic dysfunction. We examined whether Heart Rate Variability (HRV; indicator of cardiac autonomic modulation) was associated with exercise capacity in those with and without T1D. Twenty‐three participants with uncomplicated T1D and 17 matched CON were recruited. Heart rate (HR; ECG), blood pressure (BP; finger photo‐plethysmography), and respiratory rate (respiratory belt) were measured during baseline, paced‐breathing and clinical autonomic reflex tests (CARTs); deep breathing, lying‐to‐stand, and Valsalva maneuver. Baseline and paced‐breathing ECG were analyzed for HRV (frequency‐domain). Exercise capacity was determined during an incremental cycle ergometer test while V̇O2, 12‐lead ECG, and BP were measured. In uncomplicated T1D, resting HR was elevated and resting HRV metrics were reduced, indicative of altered cardiac parasympathetic modulation; this was generally undetected by the CARTs. However, BP and plasma catecholamines were not different between groups. In T1D, V̇O2max tended to be lower (P = 0.07) and HR reserve was lower (P < 0.01). Resting Total Power (TP) had stronger positive associations with V̇O2max (R 2 ≥ 0.3) than all other traditional indicators such as age, resting HR, and self‐reported exercise (R 2 = 0.042–0.3) in both T1D and CON. Alterations in cardiac autonomic modulation are an early manifestation of uncomplicated T1D. Total Power was associated with reduced exercise capacity regardless of group, and these associations were generally stronger than traditional indicators.

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“…While these complications are more common in chronic diabetes, the association is not as well described in newly-diagnosed diabetes. In a recent research article published in Diabetes Care [5], investigators recruited 163 recently diagnosed patients with type-1 diabetes mellitus, 188 patients with type-2 diabetes mellitus, and 40 age-matched controls for each group. All study participants underwent HRV assessment and spiroergometry to assess autonomic function and cardiorespiratory fitness during a hyperinsulenemic-euglycemic clamp.…”

Section: Autonomic Dysfunction and Fitness In Patients With Recently mentioning

confidence: 99%

Is pure autonomic failure an early marker for Parkinson disease, dementia with Lewy bodies, and multiple system atrophy? And other updates on recent autonomic research

Muppidi

Miglis

2017

Clin Auton Res

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Differential Patterns of Impaired Cardiorespiratory Fitness and Cardiac Autonomic Dysfunction in Recently Diagnosed Type 1 and Type 2 Diabetes

Cited by 29 publications

References 43 publications

Sedentary Patterns, Physical Activity, and Cardiorespiratory Fitness in Association to Glycemic Control in Type 2 Diabetes Patients

Sedentary Patterns, Physical Activity, and Cardiorespiratory Fitness in Association to Glycemic Control in Type 2 Diabetes Patients

Resting heart rate variability and exercise capacity in Type 1 diabetes

Is pure autonomic failure an early marker for Parkinson disease, dementia with Lewy bodies, and multiple system atrophy? And other updates on recent autonomic research

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