Low total haemoglobin mass, blood volume and aerobic capacity in men with type 1 diabetes

Abstract

Blood O₂ carrying capacity affects aerobic capacity (VO₂max). Patients with type 1 diabetes have a risk for anaemia along with renal impairment, and they often have low VO₂max. We investigated whether total haemoglobin mass (tHb-mass) and blood volume (BV) differ in men with type 1 diabetes (T1D, n = 12) presently without complications and in healthy men (CON, n = 23) (age-, anthropometry-, physical activity-matched), to seek an explanation for low VO₂max. We determined tHb-mass, BV, haemoglobin concentration ([Hb]), and VO₂max in T1D and CON. With similar (mean ± SD) [Hb] (144 vs. 145 g l(-1)), T1D had lower tHb-mass (10.1 ± 1.4 vs. 11.0 ± 1.1 g kg(-1), P < 0.05), BV (76.8 ± 9.5 vs. 83.5 ± 8.3 ml kg(-1), P < 0.05) and VO₂max (35.4 ± 4.8 vs. 44.9 ± 7.5 ml kg(-1) min(-1), P < 0.001) than CON. VO₂max correlated with tHb-mass and BV both in T1D (r = 0.71, P < 0.01 and 0.67, P < 0.05, respectively) and CON (r = 0.54, P < 0.01 and 0.66, P < 0.001, respectively), but not with [Hb]. Linear regression slopes were shallower in T1D than CON both between VO₂max and tHb-mass (2.4 and 3.6 ml kg(-1) min(-1) vs. g kg(-1), respectively) and VO₂max and BV (0.3 and 0.6 ml kg(-1) min(-1) vs. g kg(-1), respectively), indicating that T1D were unable to reach similar VO₂max than CON at a given tHb-mass and BV. In conclusion, low tHb-mass and BV partly explained low VO₂max in T1D and may provide early and more sensitive markers of blood O₂ carrying capacity than [Hb] alone.

Resting heart rate variability and exercise capacity in Type 1 diabetes

“…The level of HbA 1c (range: 49–111 mmol/mol) was not associated with V̇ O 2max , HR reserve, or max HR in uncomplicated T1D (Table ), as previously reported (Koponen et al. ). However, highly‐trained T1D athletes with poorer glycemic control (mean HBA 1c : ~62 mmol/mol vs. ~48 mmol/mol) had blunted V̇ O 2peak and peak HR (Baldi et al.…”

Haemoglobin concentration and mass as determinants of exercise performance and of surgical outcome

“…tHb-mass has also been shown to be reduced (868 ± 99 to 840 ± 94 g, p  = 0.03) following a 30-day detraining period (87% reduction in training hours) with a reciprocal decrease in ${\dot{\mathrm{V}}\mathrm{normalO}}_{2\max }$ (4.83 ± 0.29 to 4.61 ± 0.41 L · min −1 ) observed [53]. Given these findings and that tHb-mass is lower in healthy sedentary individuals than in those who are athletically trained [54], would sick patients have a lower tHb-mass by virtue of inactivity? And might the relationship between lower aerobic capacity and poorer operative outcome be in part mediated through a sedentary lifestyle-associated reduction in tHb-mass?…”

Replicating measurements of total hemoglobin mass (tHb-mass) within a single day: precision of measurement; feasibility and safety of using oxygen to expedite carbon monoxide clearance

“…tHb-mass can be measured directly using the so-called optimized carbon monoxide (CO) re-breathing method (oCOR) (see Methods and Appendix 1 for further details). In use since 2005, it has predominantly been applied to athletes in order to monitor responses to altitude training (Gore et al 2013), but more recently has been used in clinical medicine (Otto et al 2017a,b;Koponen et al 2013;Wrobel et al 2016). There is no "normal range" for tHb-mass described for healthy subjects.…”