Study Reveals Link Between Microvascular Disease and Cardiorespiratory Fitness in Type 2 Diabetes Patients

The researchers found that microvascular disease and its burden were independently associated with lower cardiorespiratory fitness (CRF) in a large cohort of adults with type 2 diabetes.

"In the study involving 4,766 individuals with type 2 diabetes, the presence of any microvascular disease heightened the risk of low CRF (aOR 1.45), with retinopathy, neuropathy, & diabetic kidney disease (DKD) demonstrating differing degrees of association (Adjusted ORs: 1.24, 1.34 & 1.44 respectively)," the researchers reported.

For this purpose, the researchers included 4,766 participants with T2D who underwent maximal exercise testing in the Look AHEAD (Action for Health in Diabetes) study at baseline. Low CRF was defined as per the Aerobics Center Longitudinal Study reference standards.

Microvascular disease was defined as having one or more DKD, retinopathy, and neuropathy. The microvascular disease burden was defined as the number of microvascular beds affected.

The following were the study’s key findings:

• Of the 4,766 participants (mean age 58.9 ± 6.7 years, 58.5% women, 66.1% White individuals), 37% had microvascular disease.
• Participants with microvascular complications in three vascular territories had a lower CFR than those without microvascular disease (mean adjusted metabolic equivalent of task [MET] 6.58 vs. 7.26).
• Participants with any microvascular disease had higher odds of low CRF than those without microvascular disease (adjusted odds ratio [OR] 1.45).
• An increasing microvascular disease burden was associated with higher odds of low CRF (for microvascular disease in three vascular territories, adjusted OR 2.82).
• Adjusted ORs for low CRF were 1.24, 1.34, and 1.44 for neuropathy, retinopathy, and DKD associations, respectively.

The study represents a significant step in understanding the complex interplay between vascular health and physical activity in diabetes management. By identifying potential targets for intervention and risk stratification, researchers aim to improve outcomes and enhance the quality of life for individuals with type 2 diabetes.

Reference:

Arnaud D. Kaze, Prasanna Santhanam, Rexford S. Ahima, Alain G. Bertoni, Justin B. Echouffo-Tcheugui; Association Between Microvascular Disease and Cardiorespiratory Fitness Among Adults With Type 2 Diabetes. Diabetes Care 2024; dc240294. https://doi.org/10.2337/dc24-0294