Heart rate dynamics during cardio-pulmonary exercise testing are associated with glycemic control in individuals with type 1 diabetes

Bjornstad, Petter, Moser, Othmar, Eckstein, Max L., McCarthy, Olivia, Deere, Rachel, Bain, Stephen C., Haahr, Hanne L., Zijlstra, Eric, Heise, Tim and Bracken, Richard M. 2018. Heart rate dynamics during cardio-pulmonary exercise testing are associated with glycemic control in individuals with type 1 diabetes. PLoS ONE 13 (4) , e0194750. 10.1371/journal.pone.0194750

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Abstract

This study investigated the degree and direction (kHR) of the heart rate to performance curve (HRPC) during cardio-pulmonary exercise (CPX) testing and explored the relationship with diabetes markers, anthropometry and exercise physiological markers in type 1 diabetes (T1DM). Material and methods Sixty-four people with T1DM (13 females; age: 34 ± 8 years; HbA1c: 7.8 ± 1% (62 ± 13 mmol.mol-1) performed a CPX test until maximum exhaustion. kHR was calculated by a second-degree polynomial representation between post-warm up and maximum power output. Adjusted stepwise linear regression analysis was performed to investigate kHR and its associations. Receiver operating characteristic (ROC) curve was performed based on kHR for groups kHR < 0.20 vs. > 0.20 in relation to HbA1c. Results We found significant relationships between kHR and HbA1c (β = -0.70, P < 0.0001), age (β = -0.23, P = 0.03) and duration of diabetes (β = 0.20, P = 0.04). Stepwise linear regression resulted in an overall adjusted R2 of 0.57 (R = 0.79, P < 0.0001). Our data revealed also significant associations between kHR and percentage of heart rate at heart rate turn point from maximum heart rate (β = 0.43, P < 0.0001) and maximum power output relativized to bodyweight (β = 0.44, P = 0.001) (overall adjusted R2 of 0.44 (R = 0.53, P < 0.0001)). ROC curve analysis based on kHR resulted in a HbA1c threshold of 7.9% (62 mmol.mol-1). Conclusion Our data demonstrate atypical HRPC during CPX testing that were mainly related to glycemic control in people with T1DM.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Centre for Trials Research (CNTRR)
Publisher:	Public Library of Science
ISSN:	1932-6203
Date of First Compliant Deposit:	27 September 2023
Date of Acceptance:	7 March 2018
Last Modified:	18 Oct 2023 14:00
URI:	https://orca.cardiff.ac.uk/id/eprint/162783

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