肥胖对2型糖尿病患者心肺耐力的影响研究  

Association of Obesity with Cardiorespiratory Fitness in Patients with Type 2 Diabetes Mellitus

作　　者：毕丽娜[1] 郑欣[1] 戚艳艳[1] 胡苏 赵丹 李畅 张燕 BI Lina;ZHENG Xin;QI Yanyan;HU Su;ZHAO Dan;LI Chang;ZHANG Yan(Department of Endocrinology,Beijing Boai Hospital,China Rehabilitation Research Center,Beijing 100068,China)

机构地区：[1]中国康复研究中心北京博爱医院内分泌科,北京市100068

出　　处：《中国全科医学》2021年第27期3420-3423,共4页Chinese General Practice

基　　金：中央级公益性科研院所基本科研业务费专项资金(2015CZ-43)。

摘　　要：背景心肺耐力与2型糖尿病的发生率和死亡率密切相关。超重、肥胖在2型糖尿病患者中一直占有很高的比例,两者是否加重了2型糖尿病患者心肺耐力的受损,目前尚不明确。目的探讨2型糖尿病患者心肺耐力的特点及超重、肥胖对2型糖尿病心肺耐力的影响。方法选取2018年12月-2019年12月于中国康复研究中心北京博爱医院内分泌科住院或门诊治疗并行症状限制性心肺运动试验的2型糖尿病患者87例,根据体质指数(BMI)将其分为正常体质量组22例、超重组27例及肥胖组38例。比较三组患者心肺耐力指标〔峰值摄氧量(peakVO_(2))、千克峰值耗氧量(peakVO_(2)/kg)、静息摄氧量(VO_(2))、峰值代谢当量(peak-METs)、peakVO_(2)占预计值的百分比(peakVO_(2)%P)以及峰值负荷(Peak-WR)〕的差异以及BMI与心肺耐力指标的相关性。结果59例(67.8%)患者peakVO_(2)/kg<20 ml·kg^(-1)·min^(-1),70例(80.5%)患者peakVO_(2)%P≤84%。三组peakVO_(2)、peakVO_(2)/kg、静息VO_(2)、peak-METs比较,差异均有统计学意义(P<0.01);其中超重组静息VO_(2)高于正常体质量组,肥胖组peakVO_(2)高于正常体质量组,肥胖组peakVO_(2)/kg、peak-METs均低于正常体质量组和超重组,静息VO_(2)高于正常体质量组和超重组(P<0.05)。三组Peak-WR、peakVO_(2)%P比较,差异无统计学意义(P>0.05)。Pearson相关分析结果显示,BMI与peakVO_(2)、静息VO_(2)、Peak-WR呈正相关(r=0.525、0.405、0.222,P<0.05);BMI与peakVO_(2)/kg、peakMETs呈负相关(r=-0.402、-0.402,P<0.01)。结论2型糖尿病患者心肺耐力普遍下降,肥胖加剧了2型糖尿病患者心肺耐力的损伤。Background Cardiorespiratory fitness(CRF)is closely related to the incidence rate and mortality of type 2 diabetes mellitus(T2DM).Overweight and obesity are prevalent in a large proportion of patients with T2DM,but it is not clear whether they deteriorate the damage of CRF.Objective To investigate the characteristics of CRF and its association with overweight and obesity in patients with T2DM.Methods We enrolled 87 T2DM inpatients and outpatients from Department of Endocrinology,Beijing Boai Hospital,China Rehabilitation Research Center from December 2018 to December 2019.They all completed symptom-limited cardiopulmonary exercise testing(CPET),and parameters such as peakVO_(2),peakVO_(2)/kg,resting VO_(2),peak-METs,peakVO_(2)%P,and Peak-WR were compared among normal weight group(n=22),overweight group(n=27)and obesity group(n=38)stratified by BMI to evaluate the association of BMI with CRF parameters.Results We noted that the level of peakVO_(2)/kg in 59 patients(67.8%)was lower than 20 ml·kg^(-1)·min^(-1),and the peakVO_(2)%P in 70 patients(80.5%)was lower than 84%.There were significant differences in the peakVO_(2),peakVO_(2)/kg,resting VO_(2),and peak-METs among the three groups(P<0.01).The resting VO_(2) of overweight group was higher than that of normal weight group(P<0.05).The peakVO_(2) of obesity group was higher than that of normal weight group(P<0.05).The obesity group had lower peakVO_(2)/kg and peak-METs and higher resting VO_(2) than other two groups(P<0.05).There were no significant differences in Peak-WR and peakVO_(2)%P across the groups(P>0.05).Pearson correlation analysis showed BMI was positively correlated with peakVO_(2),resting VO_(2),and Peak-WR(r=0.525,0.405,0.222,P<0.05),and was negatively correlated with peakVO_(2)/kg,and peakMETs(r=-0.402,-0.402,P<0.01).Conclusion It is suggested that the CRF in most T2DM decreased and the impaired CRF is further aggravated by obesity.

关 键 词：糖尿病 2型 肥胖症 心肺耐力 心肺运动试验 

分 类 号：R587.1[医药卫生—内分泌]