Arterial stiffness can predict cardiorespiratory fitness in type 2 diabetic patients?
DOI:
https://doi.org/10.15584/ejcem.2022.1.4Keywords:
augmentation index, cardiorespiratory fitness, type 2 diabetesAbstract
Introduction and aim. Arterial stiffness (AS) has been associated with reduced cardiorespiratory fitness (CRF). The aim of this study was to verify if there is a relationship between augmentations index (AIx), as an index for AS assessment, and CRF in individuals with type 2 Diabetes Mellitus (T2DM).
Material and methods. Observational cross-sectional study including 32 individuals diagnosed with T2DM who performed two evaluations: 1. Arterial stiffness assessment using SphygmoCor and 2. CRF throughout a cardiopulmonary exercise test on a treadmill ergometer. Oxycon Mobile® device was used to obtain oxygen uptake consumption at peak (V˙O2peak); oxygen uptake efficiency slope (OUES) determined by linear regression in reason of the logarithmic transformation of the ventilation and V˙O2 obtained every minute of exercise test. Statistical analysis comprised Pearson’s Correlation and linear regression analysis performed in SigmaPlot.
Results. There was a significant correlation between AS and CRF: AIx and OUES; AIx@75 and; OUES. In linear regression, AIx was determinant for V˙O2peak and OUES – AIx and; AIx@75 and V˙O2peak.
Conclusion. AS was associated with CRF in individuals with T2DM. These results contribute to the body of evidence linking arterial functional properties to CRF and suggests greater attention for this important index.
Downloads
References
Van Bortel LM, Laurent S, Boutouyrie P, et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens. 2012;30(3):445-448. doi:10.1097/HJH.0b013e32834fa8b0
Laurent S, Cockcroft J, Van Bortel L, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27(21):2588-2605. doi:10.1093/eurheartj/ehl254
Binder J, Bailey K, Seward J, et al. Aortic Augmentation Index Is Inversely Associated With Cardiorespiratory Fitness in Men Without Known Coronary Heart Disease. Am J Hypertens. 2006;19(10):1019-1024. doi:10.1016/j.amjhyper.2006.02.012
Brooks BA, Molyneaux LM, Yue DK. Augmentation of central arterial pressure in Type 2 diabetes. Published online 2001:7.
Wilkerson DP, Poole DC, Jones AM, et al. Older Type 2 diabetic males do not exhibit abnormal pulmonary oxygen uptake and muscle oxygen utilization dynamics during submaximal cycling exercise. Am J Physiol-Regul Integr Comp Physiol. 2011;300(3):R685-R692. doi:10.1152/ajpregu.00479.2010
Baldi JC, Aoina JL, Oxenham HC, Bagg W, Doughty RN. Reduced exercise arteriovenous O 2 difference in Type 2 diabetes. J Appl Physiol. 2003;94(3):1033-1038. doi:10.1152/japplphysiol.00879.2002
Baba R, Nagashima M, Goto M, et al. Oxygen uptake efficiency slope: A new index of cardiorespiratory functional reserve derived from the relation between oxygen uptake and minute ventilation during incremental exercise. J Am Coll Cardiol. 1996;28(6):1567-1572. doi:10.1016/S0735-1097(96)00412-3
Gajanand T, Wallen M, Dias K, Keating SE, Coombes JS. Utility of the oxygen uptake efficiency slope in participants with overweight/obesity and type 2 diabetes. Obes Res Clin Pract. 2019;13(1):80-81. doi:10.1016/j.orcp.2016.10.226
Augustine JA, Yoon ES, Choo J, Heffernan KS, Jae SY. The Relationship Between Cardiorespiratory Fitness and Aortic Stiffness in Women with Central Obesity. J Womens Health. 2016;25(7):680-686. doi:10.1089/jwh.2015.5314
Arena R, Arrowood JA, Fei DY, Helm S, Kraft KA. Maximal Aerobic Capacity and the Oxygen Uptake Efficiency Slope as Predictors of Large Artery Stiffness in Apparently Healthy Subjects: J Cardiopulm Rehabil Prev. 2009;29(4):248-254. doi:10.1097/HCR.0b013e3181a3338c
American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019. Diabetes Care. 2019;42(Supplement 1):S13-S28. doi:10.2337/dc19-S002
Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1081-1093. doi:10.1161/CIRCULATIONAHA.107.185649
Faludi A, Izar M, Saraiva J, et al. ATUALIZAÇÃO DA DIRETRIZ BRASILEIRA DE DISLIPIDEMIAS E PREVENÇÃO DA ATEROSCLEROSE - 2017. Arq Bras Cardiol. 2017;109(1). doi:10.5935/abc.20170121
Sociedade Brasileira de Cardiologia, ed. 7th Brazilian Guidelines of Hypertension. 2016;107:103.
World Health Organization, ed. Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation. World Health Organization; 2000.
Van Bortel LM, Laurent S, Boutouyrie P, et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity: J Hypertens. 2012;30(3):445-448. doi:10.1097/HJH.0b013e32834fa8b0
Denham J, Brown NJ, Tomaszewski M, Williams B, O’Brien BJ, Charchar FJ. Aortic augmentation index in endurance athletes: a role for cardiorespiratory fitness. Eur J Appl Physiol. 2016;116(8):1537-1544. doi:10.1007/s00421-016-3407-x
Bruce RA, Kusumi F, Hosmer D. Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease. Am Heart J. 1973;85(4):546-562. doi:10.1016/0002-8703(73)90502-4
Balady GJ, Arena R, Sietsema K, et al. Clinician’s Guide to Cardiopulmonary Exercise Testing in Adults: A Scientific Statement From the American Heart Association. Circulation. 2010;122(2):191-225. doi:10.1161/CIR.0b013e3181e52e69
SBD. Diretrizes da Sociedade Brasileira de Diabetes 2019-2020 | Request PDF. Disponível em www.diabetes.org.br. Published 2019. Accessed March 21, 2020. www.diabetes.org.br
Will G Hopkins. New View of Statistics: Effect Magnitudes. Published 2000. Accessed September 10, 2020. http://www.sportsci.org/resource/stats/effectmag.html
American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. Lippincott Williams & Wilkins; 2013.
Sociedade Brasileira de Cardiologia, ed. 7a Diretriz Brasileira de Hipertensão Arterial. Published online 2016:103.
Avolio, A. P., Van Bortel Luc M., Boutouyrie Pierre, et al. Role of Pulse Pressure Amplification in Arterial Hypertension. Hypertension. 2009;54(2):375-383. doi:10.1161/HYPERTENSIONAHA.109.134379
Janner JH, Godtfredsen NS, Ladelund S, Vestbo J, Prescott E. Aortic Augmentation Index: Reference Values in a Large Unselected Population by Means of the SphygmoCor Device. Am J Hypertens. 2010;23(2):180-185. doi:10.1038/ajh.2009.234
Chirinos JA, Kips JG, Jacobs DR, et al. Arterial Wave Reflections and Incident Cardiovascular Events and Heart Failure. J Am Coll Cardiol. 2012;60(21):2170-2177. doi:10.1016/j.jacc.2012.07.054
Solanki JD, Mehta HB, Shah CJ. Aortic pulse wave velocity and augmentation index@75 measured by oscillometric pulse wave analysis in Gujarati nonhypertensives. Vasc Investig Ther. 2018;1(2):50. doi:10.4103/VIT.VIT_10_18
Haapala EA, Lee E, Laukkanen JA. Associations of cardiorespiratory fitness, physical activity, and BMI with arterial health in middle‐aged men and women. Physiol Rep. 2020;8(10). doi:10.14814/phy2.14438
Namgoong H, Lee D, Hwang MH, Lee S. The relationship between arterial stiffness and maximal oxygen consumption in healthy young adults. J Exerc Sci Fit. 2018;16(3):73-77. doi:10.1016/j.jesf.2018.07.003
Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby DE, Webb DJ. The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol. 2000;525(Pt 1):263-270. doi:10.1111/j.1469-7793.2000.t01-1-00263.x
Green DJ, Spence A, Halliwill JR, Cable NT, Thijssen DHJ. Exercise and vascular adaptation in asymptomatic humans: Exercise training and the vasculature. Exp Physiol. 2011;96(2):57-70. doi:10.1113/expphysiol.2009.048694
Myers J, Arena R, Dewey F, et al. A cardiopulmonary exercise testing score for predicting outcomes in patients with heart failure. Am Heart J. 2008;156(6):1177-1183. doi:10.1016/j.ahj.2008.07.010
Gürdal A, Kasikcioglu E, Yakal S, Bugra Z. Impact of diabetes and diastolic dysfunction on exercise capacity in normotensive patients without coronary artery disease. Diab Vasc Dis Res. 2015;12(3):181-188. doi:10.1177/1479164114565631
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 European Journal of Clinical and Experimental Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.




