The implications of dysglycaemia on aerobic exercise and ventilatory function in cystic fibrosis

Adam J Causer, Janis K Shute, Michael H Cummings, Anthony I Shepherd, Samuel R Wallbanks, Mark I Allenby, Irantzu Arregui-Fresneda, Victoria Bright, Mary P Carroll, Gary Connett, Thomas Daniels, Tom Meredith, Zoe L Saynor

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Abstract

BACKGROUND: The development of cystic fibrosis (CF)-related diabetes (CFRD) in paediatric groups is associated with a reduced aerobic fitness. However, this has yet to be investigated in adults with more severe lung disease.

METHODS: Cardiopulmonary exercise and glycaemic control tests were retrospectively analysed in 46 adults with CF (age: 26.9 y [range: 16.3-66.5 y]; forced expiratory volume in 1s: 65.3% [range: 26.8-105.7%]; 26 males), diagnosed with CFRD (n = 19), impaired glucose tolerance (IGT; n = 8) or normal glucose tolerance (NGT; n = 19).

RESULTS: Maximal oxygen uptake (V˙O2max) was reduced in adults with IGT and CFRD compared to their age- and gender-matched counterparts with NGT (p < 0.05); however, there was no difference when lung function was included as a covariate (all p > 0.05). V˙O2max was greater in adults who experienced post-reactive hypoglycaemia vs. NGT without hypoglycaemia (p < 0.05). The frequency of ventilatory limitation (84%, 63% and 37%, respectively; p < 0.05) but not ventilation-perfusion mismatch (42%, 38% and 16%, respectively; p > 0.05), was greater with CFRD and IGT vs. NGT. There was also no difference in arterial oxygen saturation changes between groups (p > 0.05). Gender and body mass index were significant predictors of V˙O2max (adjusted R2 = 0.37, p < 0.01), but glycaemic control did not explain additional variance (p > 0.05).

CONCLUSIONS: Adults with CF-related dysglycaemia had a reduced V˙O2max compared to age- and gender-matched counterparts, due to a greater degree of CF lung disease in these populations.

Original languageEnglish
JournalJournal of Cystic Fibrosis
Early online date2 Nov 2019
DOIs
Publication statusE-pub ahead of print - 2 Nov 2019

Cite this

Causer, A. J., Shute, J. K., Cummings, M. H., Shepherd, A. I., Wallbanks, S. R., Allenby, M. I., Arregui-Fresneda, I., Bright, V., Carroll, M. P., Connett, G., Daniels, T., Meredith, T., & Saynor, Z. L. (2019). The implications of dysglycaemia on aerobic exercise and ventilatory function in cystic fibrosis. Journal of Cystic Fibrosis. https://doi.org/10.1016/j.jcf.2019.09.014