Exp Clin Endocrinol Diabetes 2017; 125(05): 301-306
DOI: 10.1055/s-0043-100102
Article
© Georg Thieme Verlag KG Stuttgart · New York

Type 2 Diabetes is Associated with Lower Cardiorespiratory Fitness Independent of Pulmonary Function in Severe Obesity

Britta Wilms
1   Cantonal Hospital St. Gallen, St. Gallen, Switzerland
4   Department of Internal Medicine I, University of Lübeck, Lübeck, Germany
,
Barbara Ernst
1   Cantonal Hospital St. Gallen, St. Gallen, Switzerland
5   eSwiss Medical & Surgical Center, St. Gallen, Switzerland
,
Martin Thurnheer
1   Cantonal Hospital St. Gallen, St. Gallen, Switzerland
5   eSwiss Medical & Surgical Center, St. Gallen, Switzerland
,
Christina M. Spengler*
2   Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
3   Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
,
Bernd Schultes*
1   Cantonal Hospital St. Gallen, St. Gallen, Switzerland
5   eSwiss Medical & Surgical Center, St. Gallen, Switzerland
› Author Affiliations
Further Information

Publication History

received 27 October 2016
revised 30 December 2016

accepted 03 January 2017

Publication Date:
13 April 2017 (online)

Abstract

Aims

Both severe obesity and type 2 diabetes (T2DM) are associated with reduced pulmonary function and reduced cardiorespiratory fitness. We investigated whether T2DM further aggravates the impaired pulmonary function and cardiorespiratory fitness in subjects with severe obesity.

Methods

In this cross-sectional study pulmonary function (forced expiratory volume within 1 s, FEV1; vital capacity, VC) was assessed in 65 severely obese subjects with T2DM (T2DM group) and 65 severely obese subjects without T2DM (non-T2DM group), pairwise matched for sex, age, weight, and height. In 30 of the matched pairs, cardiorespiratory fitness was assessed by an incremental bicycle test (peak workload, Wpeak, oxygen uptake, V̇O2,peak).

Results

FEV1 and VC did not differ between the T2DM and non-T2DM group (all p≥0.110), whereas Wpeak and V̇O2,peak - absolute values as well as relative to body mass - were significantly lower in subjects with T2DM compared to those without T2DM (all p≤0.030). Objective markers of maximal exertion, i. e., maximal heart rate and respiratory exchange ratio, did not differ between the 2 groups (both p≥0.245).

Conclusions

The presence of T2DM in subjects with severe obesity is associated with lower cardiorespiratory fitness but with no further reduction in pulmonary function compared to subjects with severe obesity but without T2DM. While the cause-effect relationship of this association is not yet clear, these findings highlight the interplay between cardiorespiratory fitness and metabolic health, even in subjects with severe obesity.

* CMS and BS contributed equally to this work