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Metabolic Response to Submaximal and Maximal Exercise in People with Severe Obesity, Prediabetes, and Diabetes

Authors
  • Battista, Francesca
  • Belligoli, Anna
  • Neunhaeuserer, Daniel
  • Gasperetti, Andrea
  • Bettini, Silvia
  • Compagnin, Chiara
  • Marchese, Riccardo
  • Quinto, Giulia
  • Bergamin, Marco
  • Vettor, Roberto
  • Busetto, Luca
  • Ermolao, Andrea
Type
Published Article
Journal
Obesity Facts
Publisher
S. Karger AG
Publication Date
Jul 30, 2021
Volume
14
Issue
4
Pages
415–424
Identifiers
DOI: 10.1159/000517589
PMID: 34344002
Source
Karger
Keywords
Disciplines
  • Research Article
License
Green
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Abstract

Introduction: Metabolic adaptations to maximal physical exercise in people with obesity (PwO) are scarcely described. This cross-sectional study evaluates the metabolic response to exercise via the respiratory exchange ratio (RER) in PwO and different degrees of glycemic control. Methods: Eighty-five PwO (body mass index 46.0 [39.0–54.0] kg/m<sup>2</sup>), that is, 32 normoglycemic (Ob-N), 25 prediabetic (Ob-preDM), and 28 diabetic (Ob-T2DM) subjects and 18 healthy subjects performed an incremental, maximal cardiopulmonary exercise test. The RER was measured at rest (RERrest) and at peak exercise (RERpeak). Results: RERpeak was significantly higher in healthy subjects than that in PwO. Among those, RERpeak was significantly higher in Ob-N than that in Ob-preDM and Ob-T2DM (1.20 [1.15–1.27] vs. 1.18 [1.10–1.22] p = 0.04 and vs. 1.14 [1.10–1.18] p < 0.001, respectively). Accordingly, ΔRER (RERpeak-RERrest) was lower in Ob-preDM and Ob-T2DM than that in Ob-N (0.32 [0.26–0.39] p = 0.04 and 0.29 [0.24–0.36] p < 0.001 vs. 0.38 [0.32–0.43], respectively), while no significant difference was found in ΔRER between Ob-preDM and Ob-T2DM and not even between Ob-N and healthy subjects. Moreover, ΔRER in PwO correlated with glucose area under curve (p = 0.002). Conclusions: PwO demonstrate restricted metabolic response during maximal exercise. Particularly, those with prediabetes already show metabolic inflexibility during exercise, similarly to those with type 2 diabetes. These findings also suggest a potential role of cardiopulmonary exercise testing in detecting early metabolic alterations in PwO.

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