Exercise Capacity and Cardiovascular/Metabolic Characteristics of Overweight and Obese Individuals with Type 2 Diabetes. The Look AHEAD Study
- Paul M. Ribisl, PHD (ribisl{at}wfu.edu)1,
- Wei Lang, PHD2,
- Sarah A Jaramillo, MS2,
- John M Jakicic, PHD3,
- Kerry J. Stewart, EDD4,
- Judy Bahnson, MS2,
- Renee Bright, MS5,
- Jeff F. Curtis, MD6,
- Richard S. Crow, MD7,
- Judith E. Soberman, MD8 and
- the Look AHEAD Research Group
- 1Wake Forest University, Winston-Salem, NC27109 (ribisl@wfu.edu)
- 2Wake Forest University School of Medicine, Winston-Salem, NC 27157 (wlang@wfubmc.edu; sjaramil@wfubmc.edu;jbahnson@wfubmc.edu)
- 3The University of Pittsburgh, Pittsburgh, PA 15203 (jjakicic@pitt.edu)
- 4Johns Hopkins University, Baltimore, MD 21224 (kstewart@mail.jhmi.edu)
- 5 Brown Medical School/The Miriam Hospital, Brown University, Providence, RI 02906 (rbright@lifespan.org)
- 6 Diabetes Epidemiology and Clinical Research Section, NIDDK, Phoenix, AZ 85014; (jfcurtis@mail.nih.gov)
- 7University of Minnesota, Minneapolis, MN 55415 (crow@epi.umn.edu)
- 8The University of Tennessee, Memphis, TN 38163 (jsoberman@utmem.edu)
Abstract
OBJECTIVE -- We examined associations of cardiovascular, metabolic, and body composition measures with exercise capacity using baseline data from 5145 overweight and/or obese (BMI U≥U 25.0) men and women with type 2 diabetes (T2DM) who were randomized participants for the Look AHEAD clinical trial.
RESEARCH DESIGN AND METHODS -- Peak exercise capacity expressed as metabolic equivalents (METs) and estimated from treadmill speed and grade was measured during a graded exercise test (GXT) that was designed to elicit a maximal effort. Other measures included: waist circumference, BMI, T2DM duration, types of medication used, HbA1c, history of cardiovascular disease, metabolic syndrome, beta blockers use, race/ethnicity.
RESULTS -- Peak exercise capacity was higher for males (8.0 ± 2.1 METs) compared to females (6.7 ± 1.7 METs) (p<0.001). Exercise capacity also decreased across each decade of age (p<0.001) as well as with increasing BMI and waist circumference levels in both genders. Older age, increased waist circumference and BMI, a longer duration of diabetes, increased HbA1c, a history of CVD, having metabolic syndrome, beta blocker use, and being African American compared to white, were associated with a lower peak exercise capacity for both genders. Hypertension and use of diabetic medications were associated with lower peak exercise capacity in females.
CONCLUSIONS -- Among persons with diabetes who are overweight or obese have impaired exercise capacity, which is primarily related to: age, female sex, and race as well as poor metabolic control, BMI, and central obesity.
Footnotes
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- Received December 7, 2007.
- Accepted July 12, 2007.
- Copyright © American Diabetes Association
