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Exercise excess pressure and exercise-induced albuminuria in patients with type 2 diabetes mellitus

Citation

Climie, RED and Srikanth, V and Keith, LJ and Davies, JE and Sharman, JE, Exercise excess pressure and exercise-induced albuminuria in patients with type 2 diabetes mellitus, American Journal of Physiology: Heart and Circulatory Physiology, 308, (9) pp. H1136-H1142. ISSN 0363-6135 (2015) [Refereed Article]

Copyright Statement

Copyright 2015 American Physiological Society

DOI: doi:10.1152/ajpheart.00739.2014

Abstract

Exercise-induced albuminuria is common in patients with type 2 diabetes mellitus (T2DM) in response to maximal exercise, but the response to light-moderate exercise is unclear. Patients with T2DM have abnormal central hemodynamics and greater propensity for exercise hypertension. This study sought to determine the relationship between light-moderate exercise central hemodynamics (including aortic reservoir and excess pressure) and exercise-induced albuminuria. Thirty-nine T2DM (62  9 yr; 49% male) and 39 nondiabetic controls (53  9 yr; 51% male) were examined at rest and during 20 min of light-moderate cycle exercise (30 W; 50 revolutions/min). Albuminuria was assessed by the albumin-creatinine ratio (ACR) at rest and 30 min postexercise. Hemodynamics recorded included brachial and central blood pressure (BP), aortic stiffness, augmented pressure (AP), aortic reservoir pressure, and excess pressure integral (Pexcess). There was no difference in ACR between groups before exercise (P > 0.05). Exercise induced a significant rise in ACR in T2DM but not controls (1.73  1.43 vs. 0.53  1.0 mg/mol, P = 0.002). All central hemodynamic variables were significantly higher during exercise in T2DM (i.e., Pexcess, systolic BP and AP; P < 0.01 all). In T2DM (but not controls), exercise Pexcess was associated with postexercise ACR (r = 0.51, P = 0.002), and this relationship was independent of age, sex, body mass index, heart rate, aortic stiffness, antihypertensive medication, and ambulatory daytime systolic BP (β = 0.003, P = 0.003). Light-moderate exercise induced a significant rise in ACR in T2DM, and this was independently associated with Pexcess, a potential marker of vascular dysfunction. These novel findings suggest that Pexcess could be important for appropriate renal function in T2DM.

Item Details

Item Type:Refereed Article
Keywords:exercise blood pressure, physiology, renal dysfunction
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Climie, RED (Miss Rachel Climie)
Author:Srikanth, V (Dr Velandai Srikanth)
Author:Keith, LJ (Miss Laura Keith)
Author:Sharman, JE (Professor James Sharman)
ID Code:100970
Year Published:2015
Web of Science® Times Cited:8
Deposited By:Menzies Institute for Medical Research
Deposited On:2015-06-04
Last Modified:2016-02-17
Downloads:0

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