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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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
Pages (from-to)427-433
Number of pages7
JournalJournal of Cystic Fibrosis
Issue number3
Early online date2 Nov 2019
Publication statusPublished - 1 May 2020


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


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