Typ-2-Diabetes ist bei schwerer Adipositas mit einer Verringerung der kardiorespiratorischen Fitness – jedoch nicht der Lungenfunktion – assoziiert

Zusammenfassung

Ziel Sowohl schwere Formen der Adipositas als auch des Typ-2-Diabetes (T2DM) gehen mit einer verringerten Lungenfunktion und einer schlechteren kardiorespiratorischen Fitness einher. Wir untersuchten, ob das zusätzliche Vorliegen einer T2DM-Erkrankung die bereits beeinträchtigte Lungenfunktion und kardiorespiratorische Fitness bei Personen mit schwerer Adipositas weiter limitiert.

Methoden In dieser Querschnittsstudie wurde die Lungenfunktion (Einsekundenkapazität FEV₁; Vitalkapazität, VC) bei 65 Probanden mit schwerer Adipositas und T2DM (T2DM-Gruppe) und 65 schwer adipösen Personen ohne T2DM (Nicht-T2DM-Gruppe), die paarweise nach Geschlecht, Alter, Körpermasse und -größe zugeordent wurden, bestimmt. Bei 30 dieser gematchten Paare wurde die kardiorespiratorische Fitness (maximale Leistung, W_peak, maximale Sauerstoffaufnahme, V O_2peak) im Fahrrad-Stufentest ermittelt.

Ergebnisse Zwischen der T2DM- und der Nicht-T2DM-Gruppe bestanden keine Unterschiede bezüglich FEV₁ und VC (alle p ≥ 0,110), wohingegen W_peak und V O_2peak –sowohl absolut als auch relativ zur Körpermasse – in der T2DM-Gruppe signifikant niedriger waren, als in der nicht-T2DM-Gruppe (alle p ≤ 0,030). Objektive Marker der Ausbelastung d. h. die maximale Herzfrequenz und der respiratorische Quotient, unterschieden sich zwischen beiden Gruppen nicht (beide p ≥ 0,245).

Schlussfolgerung Das Vorliegen einer T2DM-Erkrankung bei Personen mit schwerer Adipositas ist mit einer geringeren kardiorespiratorischen Fitness assoziiert, geht jedoch nicht mit einer weiteren Einschränkung der Lungenfunktion einher, im Vergleich zu Personen mit schwerer Adipositas, jedoch ohne T2DM. Obwohl die zugrunde liegenden Mechanismen noch nicht vollständig bekannt sind, verdeutlichen diese Befunde das Zusammenspiel von kardiorespiratorischer Fitness und dem Metabolismus, auch bei Personen mit schwerer Adipositas.

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, W_peak, oxygen uptake, V O_{2, peak}).

Results FEV1 and VC did not differ between the T2DM and non-T2DM group (all p≥ 0.110), whereas W_peak and V O_{2, 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.

Schlüsselwörter

Sauerstoffaufnahme - Herzfrequenz - Ergospirometrie - Spirometrie - BMI - Glukose

Key words

oxygen uptake - heart rate - ergospirometry - spirometry - bmi - glucose

^* gleichberechtigte Autorenschaft.

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