From Rest to Stressed: Adults with Type 2 Diabetes Exhibit a Greater Exercise‐Induced Increase in Arterial Stiffness and Vessel Hemodynamics
Notice bibliographique
Résumé
Objective Individuals with type 2 diabetes mellitus (T2DM) are known to have a greater blood pressure (BP) response to acute maximal exercise. The nature of this exaggerated response is likely a function of vascular abnormalities; therefore, we aimed to examine the exercise‐induced response of carotid‐femoral pulse wave velocity (cfPWV), the gold‐standard measure of arterial stiffness, and other vessel hemodynamic parameters in adults with and without T2DM. Methods Adults with T2DM (n=77) and without T2DM (n=105) underwent an exercise test to volitional exhaustion on a treadmill (following a modified Bruce protocol). Using applanation tonometry (SphygmoCor), cfPWV and augmentation index corrected for a heart rate (HR) of 75 beats/min (AIx75) were assessed at rest, and immediately following exercise termination. At the same time points, peripheral BP, and HR were measured with an automated oscillometric BP monitor (BPTru). Linear regression models were used to evaluate between‐group differences in parameters at rest, as well as the absolute change of each parameter in response to exercise, with adjustments for exercise time and the baseline value. Results Mean age was 59.0±11.0 years and body mass index was 31.5±4.0 kg/m 2 (non‐significantly different between groups). All subjects had hypertension and were taking anti‐hypertensive medication (mean BP 130±14/80±9 mmHg). At rest, subjects with T2DM had significantly higher cfPWV (10.2±2.5 vs. 9.3±1.8 m/s), HR (70±12 vs. 66±10 beats/min), and lower diastolic BP (80±9 vs. 83±9 mmHg), but no significant difference in systolic BP (118±14 vs. 121±12 mmHg) or AIx75 (23±9 vs. 23±10%). In response to exercise, subjects with T2DM had a significantly greater increase in cfPWV by 1.3 m/s (95% CI 0.1, 2.4), systolic BP by 11.2 mmHg (95% CI 2.9, 19.5) and pulse pressure (PP) by 5.63 mmHg (95%CI 0.19, 11.08). A greater number of subjects with T2DM had a hypertensive (systolic BP>210 mmHg in men, and >190 mmHg in women) response to exercise (n=31, 30%) compared to subjects without T2DM (n=14, 18%). The increase in AIx75 was significantly lower in subjects with T2DM by 2.6% (95% CI −4.9, −0.2). Conclusion By incorporating exercise as a vascular stressor, we provide evidence of a greater increase in arterial stiffness, independently of exercise time and resting arterial stiffness. Despite no differences in systolic BP or PP at rest, we observed an exaggerated systolic BP response in subjects with T2DM, and importantly an altered arterial stiffness response to acute exercise. Therefore, evaluating the exercise‐induced response of arterial stiffness and hemodynamic parameters may serve as a useful model for evaluating vascular impairment and CVD risk in adults with T2DM. Support or Funding Information This work was funded by the Canadian Institutes of Health Research (CIHR). KD and SSD hold salary awards from the Fonds de recherche du Québec‐Santé. ABC holds a PhD award from CIHR. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».