Impaired aerobic work capacity in insulin dependent diabetics with increased urinary albumin excretion
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Impaired aerobic work capacity in insulin dependent diabetics with increased urinary albumin excretion. / Jensen, T; Richter, Erik A.; Feldt-Rasmussen, Bo; Kelbæk, H; Deckert, T.
In: British medical journal (Clinical research ed.), Vol. 296, No. 6633, 1988, p. 1352-1354.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Impaired aerobic work capacity in insulin dependent diabetics with increased urinary albumin excretion
AU - Jensen, T
AU - Richter, Erik A.
AU - Feldt-Rasmussen, Bo
AU - Kelbæk, H
AU - Deckert, T
PY - 1988
Y1 - 1988
N2 - To assess whether decreased aerobic work capacity was associated with albuminuria in insulin dependent diabetics aerobic capacity was measured in three groups of 10 patients matched for age, sex, duration of diabetes, and degree of physical activity. Group 1 comprised 10 patients with normal urinary albumin excretion (less than 30 mg/24 h), group 2 comprised 10 with incipient diabetic nephropathy (urinary albumin excretion 30-300 mg/24 h, and group 3 comprised 10 with clinical diabetic nephropathy (urinary albumin excretion greater than 300 mg/24 h). Ten non-diabetic subjects matched for sex, age, and physical activity served as controls. Oxygen uptake was similar in the four groups at rest and during a 75 W workload. Maximal oxygen uptake was also similar in the control subjects and group 1 (median 41.7, (range 29.1-53.0) ml/kg/min v 38.5 (26.6-59.2) ml/kg/min, respectively), but was significantly lower in group 2 (27.7 (13.9-44.3) ml/kg/min) and group 3 (22.6-36.7) ml/kg/min). The difference in maximal oxygen uptake between groups 1 and 2 was 10.8 ml/kg/min (95% confidence interval 3.6 to 23.4 ml/kg/min) and between groups 1 and 3, 11.7 ml/kg/min (4.9 to 22.5 ml/kg/min). These differences were not explained by differences in metabolic control or the degree of autonomic neuropathy. Thus the insulin dependent diabetics with only slightly increased urinary albumin excretion had an appreciably impaired aerobic work capacity which could not be explained by autonomic neuropathy or the duration of diabetes. Whether the reduced capacity is due to widespread microangiopathy or another pathological process affecting the myocardium remains to be established.
AB - To assess whether decreased aerobic work capacity was associated with albuminuria in insulin dependent diabetics aerobic capacity was measured in three groups of 10 patients matched for age, sex, duration of diabetes, and degree of physical activity. Group 1 comprised 10 patients with normal urinary albumin excretion (less than 30 mg/24 h), group 2 comprised 10 with incipient diabetic nephropathy (urinary albumin excretion 30-300 mg/24 h, and group 3 comprised 10 with clinical diabetic nephropathy (urinary albumin excretion greater than 300 mg/24 h). Ten non-diabetic subjects matched for sex, age, and physical activity served as controls. Oxygen uptake was similar in the four groups at rest and during a 75 W workload. Maximal oxygen uptake was also similar in the control subjects and group 1 (median 41.7, (range 29.1-53.0) ml/kg/min v 38.5 (26.6-59.2) ml/kg/min, respectively), but was significantly lower in group 2 (27.7 (13.9-44.3) ml/kg/min) and group 3 (22.6-36.7) ml/kg/min). The difference in maximal oxygen uptake between groups 1 and 2 was 10.8 ml/kg/min (95% confidence interval 3.6 to 23.4 ml/kg/min) and between groups 1 and 3, 11.7 ml/kg/min (4.9 to 22.5 ml/kg/min). These differences were not explained by differences in metabolic control or the degree of autonomic neuropathy. Thus the insulin dependent diabetics with only slightly increased urinary albumin excretion had an appreciably impaired aerobic work capacity which could not be explained by autonomic neuropathy or the duration of diabetes. Whether the reduced capacity is due to widespread microangiopathy or another pathological process affecting the myocardium remains to be established.
KW - Adolescent
KW - Adult
KW - Albuminuria
KW - Diabetes Mellitus, Type 1
KW - Female
KW - Heart
KW - Heart Rate
KW - Humans
KW - Lactates
KW - Lactic Acid
KW - Male
KW - Middle Aged
KW - Oxygen Consumption
KW - Work Capacity Evaluation
M3 - Journal article
C2 - 3134983
VL - 296
SP - 1352
EP - 1354
JO - British medical journal
JF - British medical journal
SN - 0007-1447
IS - 6633
ER -
ID: 154757533