Key result
T2D patients exhibit ~15% lower maximum cardiac power output during exercise versus obese patients.
Why the study?
Impaired exercise capacity influences obesity and diabetes disease progression and vice versa, but cardiac and peripheral muscular capacity markers during exercise remained to be characterized.
Does a standard of care lifestyle and exercise intervention improve cardiac and peripheral muscular capacity in patients with obesity or type II diabetes mellitus?
Observational (n=82)
No
Does a standard of care lifestyle and exercise intervention improve cardiac and peripheral muscular capacity in patients with obesity or type II diabetes mellitus?
Absolute Event Rate: 4.81% vs 5.67%
p-value: p=<0.01
Obese patients are primarily limited by muscular performance during exercise, whereas diabetic patients exhibit both muscular and cardiac limitations, though both groups improve peripheral oxygen extraction with resistance training.
Type 2 diabetes is associated with greater cardiac limitations than obesity during exercise; leaves open whether training improves cardiac power output differentially.
Background Impaired exercise capacity influences obesity and diabetes disease progression and vice versa. The primary objective of this prospective, observational, real-world study was to characterize exercise capacity in patients with obesity or type II diabetes mellitus and healthy controls by cardiac capacity (cardiac output (CO), cardiac power output (CPO)) and peripheral muscle capacity (peak power output (Pmax) and arterio-venous oxygen difference (avDO2)). The effects of an exercise and lifestyle intervention on these cardiac and peripheral muscular markers in obese and diabetic patient groups were additionally evaluated. Methods At a university sports medicine outpatient clinic, 24 obese (OB) and 38 diabetes mellitus type II (DM) patients and 20 healthy controls (HE) were investigated in a cross-sectional analysis. OB and DM were reexamined after a standard of care exercise intervention. Parameters were assessed at rest and during a cardiopulmonary exercise test (CPET). Blood pressure, impedance cardiography, and respiratory gas analysis were continuously recorded during CPET. Results At Pmax, CO and CPO were lower in DM compared to obese (CO 16.26 l/min vs. 18.13 l/min, p < 0.04; CPO 5.67 W vs. 4.81 W, p < 0.01). HE did not differ in CO (18.19 l/min)) or CPO (5.27 W) from OB and DM. Maximum CPO in OB and DM was based on higher stroke volume and blood pressure, while HE had higher heart rates. Pmax was higher ( p < 0.01) in HE (268 W) compared to OB (108 W) and DM (89 W), mainly caused by a higher ( p < 0.01) avDO 2 (HE 18.22 ml/dl, OB 10.45 ml/dl, DM 9.65 ml/dl). Exercise intervention improved Pmax in both groups of patients (+ 16 W in OB, + 12 W in DM), which was attributed to increased avDO 2 , but not to cardiac parameters. Conclusions Obese patients had higher cardiac power outputs and were primarily limited by muscular performance, while diabetic patients showed both muscular and cardiac limitations. Healthy subjects had comparable cardiac power outputs with significantly lower pressure-volume loads. Resistance training improved the alteration of our patient groups in exercise capacity. Future research is needed to interpret our findings regarding clinical endpoints, such as mortality and hospitalization. Trial registration The study was retrograde registered in the German Clinical Trial Register (DRKS00032545, 24.08.2023).
No takes yet. Share an insight, caveat, or question.
Kwast et al. (2025) conducted an observational in Obesity and Type II Diabetes Mellitus (n=82). Type II Diabetes Mellitus vs. Obesity was evaluated on Cardiac power output (CPO) at maximum load (p=<0.01). Patients with type II diabetes exhibited significantly lower maximum cardiac power output (4.81 W) compared to obese patients (5.67 W) during exercise.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: