The final, formatted version of the article will be published soon.
ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Volume 12 - 2025 |
doi: 10.3389/fcvm.2025.1485755
Type 2 Diabetes Mellitus' Impact on Heart Failure Patients' Exercise Tolerance: A Focus on Maximal Fat Oxidation During Exercise
Provisionally accepted
Huiying Zhu 1*
Jianchao Pan 2 Jianxuan Wen 1 Xiaojing Dang 1
Xiankun Chen 1 Yunxiang Fan 1
Weihui Lu 1
Wei Jiang 1*- 1 The Second Affiliated Hospital, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- 2 The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
Objective: To explore the impact of type 2 diabetes mellitus (T2DM) on exercise tolerance and fat oxidation capacity in patients with heart failure (HF).We retrospectively analyzed 108 Chinese patients with HF who were divided into a diabetic group (T2DM group, n=47) and a non-diabetic group (non-T2DM group, n=61). All subjects completed cardiopulmonary exercise testing (CPX). We determined their fat oxidation (FATox) by indirect calorimetry.In the HF patients, the peak oxygen uptake (VO2) value was 14.76±3.27 mL/kg/min in the T2DM group and 17.76±4.64 mL/kg/min in the non-T2DM group.After adjusting for age, sex, body mass index (BMI), log N-terminal pro-B type natriuretic peptide (log NT-proBNP), left ventricular ejection fraction (LVEF), hemoglobin, renal function, coronary heart disease and hypertension, the peak VO2 was lower in the T2DM group compared to the non-T2DM group with a mean difference (MD) of -2.0 mL/kg/min (95% confidence interval [CI], -3.18 to -0.82, P<0.01). The VO2 at anaerobic threshold (AT VO2) was also lower in the T2DM group than in the non-T2DM group, with a MD of -1.11 mL/kg/min (95% CI -2.04 to -0.18, P<0.05).Regarding the fat oxidation capacity during CPX, the T2DM group's maximal fat oxidation (MFO) was lower than that of the non-T2DM group (0.143±0.055 vs. 0.169±0.061 g/min, P<0.05). In addition, the T2DM group had lower FATox at exercise intensity levels of 40% (P<0.05) and 50% (P<0.05) of peak VO2, compared to the non-T2DM group.Conclusions: T2DM is associated with a decrease in exercise tolerance and fat oxidation capacity in patients with heart failure. Thus, it could be useful to develop 3 exercises of appropriate intensity to optimize physical and metabolic health.
Keywords: Heart Failure, type 2 diabetes mellitus, Exercise Tolerance, Maximal fat oxidation, fat oxidation
Received: 24 Aug 2024; Accepted: 27 Jan 2025.
Copyright: © 2025 Zhu, Pan, Wen, Dang, Chen, Fan, Lu and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Huiying Zhu, The Second Affiliated Hospital, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
Wei Jiang, The Second Affiliated Hospital, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.