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

Adam John Causer; Jan Shute; Michael H. Cummings; Ant Shepherd; Samual R. Wallbanks; Mark I. Allenby; Irantzu Arregui-Fresneda; Victoria Bright; Mary P. Carroll; Gary Connett; Thomas Daniels; Tom Meredith; Zoe Saynor

doi:10.1016/j.jcf.2019.09.014

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

Adam John Causer, Jan Shute, Michael H. Cummings, Ant Shepherd, Samual R. Wallbanks, Mark I. Allenby, Irantzu Arregui-Fresneda, Victoria Bright, Mary P. Carroll, Gary Connett, Thomas Daniels, Tom Meredith, Zoe 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 ̇O_2max) 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 ̇O_2max 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 ̇O_2max (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 ̇O_2max compared to age- and gender-matched counterparts, due to a greater degree of CF lung disease in these populations.

Original language	English
Pages (from-to)	427-433
Number of pages	7
Journal	Journal of Cystic Fibrosis
Volume	19
Issue number	3
Early online date	2 Nov 2019
DOIs	https://doi.org/10.1016/j.jcf.2019.09.014
Publication status	Published - 1 May 2020

Keywords

cardiorespiratory fitness
cystic fibrosis-related diabetes
maximal oxygen uptake
respiratory disease

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jcf.2019.09.014

The implications of dysglycaemiaAccepted author manuscript (Post-print), 721 KBLicence: CC BY-NC-ND

Cite this

Causer, A. J., Shute, J., Cummings, M. H., Shepherd, A., Wallbanks, S. R., Allenby, M. I., Arregui-Fresneda, I., Bright, V., Carroll, M. P., Connett, G., Daniels, T., Meredith, T., & Saynor, Z. (2020). The implications of dysglycaemia on aerobic exercise and ventilatory function in cystic fibrosis. Journal of Cystic Fibrosis, 19(3), 427-433. https://doi.org/10.1016/j.jcf.2019.09.014

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title = "The implications of dysglycaemia on aerobic exercise and ventilatory function in cystic fibrosis",

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. ",

keywords = "cardiorespiratory fitness, cystic fibrosis-related diabetes, maximal oxygen uptake, respiratory disease",

author = "Causer, {Adam John} and Jan Shute and Cummings, {Michael H.} and Ant Shepherd and Wallbanks, {Samual R.} and Allenby, {Mark I.} and Irantzu Arregui-Fresneda and Victoria Bright and Carroll, {Mary P.} and Gary Connett and Thomas Daniels and Tom Meredith and Zoe Saynor",

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Causer, AJ, Shute, J, Cummings, MH , Shepherd, A, Wallbanks, SR, Allenby, MI, Arregui-Fresneda, I, Bright, V, Carroll, MP, Connett, G, Daniels, T, Meredith, T & Saynor, Z 2020, 'The implications of dysglycaemia on aerobic exercise and ventilatory function in cystic fibrosis', Journal of Cystic Fibrosis, vol. 19, no. 3, pp. 427-433. https://doi.org/10.1016/j.jcf.2019.09.014

TY - JOUR

T1 - The implications of dysglycaemia on aerobic exercise and ventilatory function in cystic fibrosis

AU - Causer, Adam John

AU - Shute, Jan

AU - Cummings, Michael H.

AU - Shepherd, Ant

AU - Wallbanks, Samual R.

AU - Allenby, Mark I.

AU - Arregui-Fresneda, Irantzu

AU - Bright, Victoria

AU - Carroll, Mary P.

AU - Connett, Gary

AU - Daniels, Thomas

AU - Meredith, Tom

AU - Saynor, Zoe

N1 - 12 months embargo. Elsevier.

PY - 2020/5/1

Y1 - 2020/5/1

N2 - 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.

AB - 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.

KW - cardiorespiratory fitness

KW - cystic fibrosis-related diabetes

KW - maximal oxygen uptake

KW - respiratory disease

U2 - 10.1016/j.jcf.2019.09.014

DO - 10.1016/j.jcf.2019.09.014

M3 - Article

SN - 1569-1993

VL - 19

SP - 427

EP - 433

JO - Journal of Cystic Fibrosis

JF - Journal of Cystic Fibrosis

IS - 3

ER -

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

Abstract

Keywords

UN SDGs

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