Distinct effects of type 2 diabetes and obesity on cardiopulmonary performance

• DOI: 10.1111/dom.15324
• Publication Date: 2023-10-13T06:34:39Z
• Authors: Lorenzo Nesti; Nicola Riccardo P...; Lorenza Santoni; Silvia Armenia; Martina Chiriacò; Luca Sacchetta; Nicolò De Biase; Lavinia Del Punta; Stefano Masi; Domenico Tricò; Andrea Natali
• Keywords: 2. Zero hunger; Oxygen; Oxygen Consumption; Diabetes Mellitus, Type 2; Echocardiography; Exercise Test; Humans; Obesity; CPET; cardiopulmonary exercise test; cardiovascular complications; echocardiography; effort intolerance; exercise physiology; heart failure; speckle tracking; type 2 diabetes; 3. Good health

Effort intolerance is frequent in patients with overweight/obesity and/or type 2 diabetes (T2D) free from cardiac and respiratory disease. We sought to quantify the independent effects of T2D body mass index (BMI) on cardiopulmonary capacity gain insights possible pathophysiology by case-control regression analyses.Patients at high/moderate cardiovascular risk, or without T2D, underwent spirometry combined echocardiography-cardiopulmonary exercise test as part their clinical workup. Subjects evidence disease were excluded. The obesity estimated multivariable models accounting for known/potential confounders major pathophysiological determinants oxygen uptake peak (VO2peak ) normalized fat-free (FFM).In total, 109 97 controls included analysis. two groups had similar demographic anthropometric characteristics except higher BMI (28.6 ± 4.6 vs. 26.3 4.4 kg/m2 , p = .0003) but comparable FFM. Patients achieved lower VO2peak than (18.5 21.7 8.3 ml/min/kg, .0006). Subclinical dysfunctions observed T2D: concentric left ventricular remodelling, autonomic dysfunction, systolic dysfunction reduced reserve. After VO2peakFFM still displayed 1.0 (-1.7/-0.3) ml/min/kgFFM .0089, while effect [-0.2 (-0.3/0.1) .06 per unit increase], was largely explained a combination chronotropic incompetence, peripheral extraction, impaired reserve ventilatory (in)efficiency.T2D an negative determinant whose additive other uptake, including BMI.