Relationships between cardiorespiratory fitness, metabolic control, and fat distribution in type 2 diabetes subjects

Abstract

Factors contributing to the reduced cardiorespiratory fitness typical of sedentary subjects with type 2 diabetes are still largely unknown. In this study, we assessed the relationships between cardiorespiratory fitness and abdominal and skeletal muscle fat content in 39 untrained type 2 diabetes subjects, 27 males and 12 females (mean ± SD age 56.5 ± 7.3 year, BMI 29.4 ± 4.7 kg/m(2)). Peak oxygen uptake (VO2peak) and ventilatory threshold (VO2VT) were assessed by maximal cycle ergometer exercise test, insulin sensitivity by euglycemic-hyperinsulinemic clamp, and body composition by dual-energy X-ray absorptiometry. Magnetic resonance imaging was used to evaluate visceral, total subcutaneous (SAT), superficial (SSAT) and deep sub-depots of subcutaneous abdominal adipose tissue, and sagittal abdominal diameter (SAD), as well as femoral quadriceps skeletal muscle fat content. In univariate analysis, both VO2peak and VO2VT were inversely associated with BMI, total fat mass, SAT, SSAT, and sagittal abdominal diameter. VO2peak was also inversely associated with skeletal muscle fat content. A significant direct association was observed between VO2VT and insulin sensitivity. No associations between cardiorespiratory fitness parameters and metabolic profile data were found. In multivariable regression analysis, after adjusting for age and gender, VO2peak was independently predicted by higher HDL cholesterol, and lower SAD and skeletal muscle fat content (R (2) = 0.64, p < 0.001), whereas VO2VT was predicted only by sagittal abdominal diameter (R (2) = 0.48, p = 0.025). In conclusion, in untrained type 2 diabetes subjects, peak oxygen uptake is associated with sagittal abdominal diameter, skeletal muscle fat content, and HDL cholesterol levels. Future research should target these features in prospective intervention studies.

Exercise capacity in diabetes mellitus is predicted by activity status and cardiac size rather than cardiac function: a case control study

“…Chronic hyperglycemia is associated with endothelial dysfunction and microvascular disease, and a causal link with congestive heart failure (CHF) and reduced exercise capacity [ 2 ] has been proposed. In contrast to previous investigations [ 13 , 14 ], we observed a significant inverse correlation between HbA1c and peak in our cohort. However, this association was largely abolished when other confounding factors such as diabetic status, age and sex were included in the multivariate model.…”

Regional Adipose Distribution and its Relationship to Exercise Intolerance in Older Obese Patients Who Have Heart Failure With Preserved Ejection Fraction

“…(7,9,14,16) Emerging data suggest that, in addition to the amount of total body adipose tissue, the specific location of adipose tissue may play a role in adverse outcomes, including exercise intolerance. (4,14,17,18) However, the impact of adipose distribution on exercise performance has not been systematically examined in HFpEF.…”

<p>Age-Related Changes in Body Composition and Bone Mineral Density and Their Relationship with the Duration of Diabetes and Glycaemic Control in Type 2 Diabetes</p>

“…For example, fat regional distribution affects the relationship among obesity, metabolism and health and plays an important role in cardiovascular and metabolic diseases. 1,2 Lean mass and BMD decreases result in an increased risk of oligomyopathy, osteoporosis and fracture in elderly individuals.…”