第1型糖尿病患者之心肺適能、肺功能、肌肉氧氣飽和度及生活品質

Abstract

Background: Cardiopulmonary fitness has been reported to correlate with life expectancy in patients with type 1 diabetes mellitus (T1DM). Compared to healthy exercisers, patients with T1DM tend to have reduced cardiopulmonary fitness and lung function. However, the interrelationships with lung function, muscular oxygen saturation, and quality of life (QOL) are yet to be investigated. Purpose: The purposes of this study were (1) to compare cardiopulmonary fitness, lung function, muscle oxygen saturation, and QOL between T1DM patients and healthy controls; and (2) to investigate the relationship between cardiopulmonary fitness and other variables of interest in T1DM patients. Methods: Twenty T1DM patients, aged 33.5±10.1 years, and 20 age-, gender-, and body mass index-matched healthy controls were recruited. Besides the basic and clinical characteristics, all participants took measurements of a symptom-limited exercise testing with concurrent near-infrared spectroscopy and bioreactance cardiac output monitoring, pulmonary function test with lung diffusing capacity (DLCO) measurement, and the Short-Form 36. Results: After adjusting physical activity, compared to healthy controls, T1DM patients had significantly lower VO2peak (26.2±6.7 ml/min/kg vs. 31.5±6.2 ml/min/kg), (a-v)O2diff at peak exercise (13.3±2.8 vs. 15.5±3.7 ml/100ml), DLCO (92±14 vs. 104±13% predicted), and lower total score in SF-36 and subscales of general healthand social functioning. VO2peak was moderately correlated with FVC, FEV1, DLCO, (a-v)O2diff, and physical activity level. In multiple regression analysis, HbA1C had significant impact on %predicted FVC (β=－0.52) and SF-36 total score, while physical activity level significantly correlated with %predicted VO2 and stroke volume at peak exercise. Conclusion: Patients with T1DM had lower cardiopulmonary fitness, lung diffusing capacity and QOL than their healthy controls. Glycemic control and physical activity significantly correlated with cardiopulmonary fitness, lung function, and QOL, thus it is important to improve their glycemic control and physical activity level clinically.