Impaired cerebral blood flow and oxygenation during exercise in type 2 diabetic patients.
Impaired cerebral blood flow and oxygenation during exercise in type 2 diabetic patients.
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DOI：
10.14814/phy2.12430
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发表时间：
2015-06
影响因子：
2.5
通讯作者：
van Lieshout JJ
中科院分区：
文献类型：
--
作者：
Kim YS;Seifert T;Brassard P;Rasmussen P;Vaag A;Nielsen HB;Secher NH;van Lieshout JJ
2型糖尿病（T2DM）患者运动时内皮血管功能和增加心输出量的能力受损。我们验证了这样一种假设，即运动期间脑血流量（CBF）的增加也被钝化，因此，脑氧合受到影响，T2DM患者的感知运动增加。我们量化了8名男性2型糖尿病患者和7名对照受试者在脚踏车运动后的脑血管和全身血流动力学反应。CBF由菲克方程和经颅多普勒测定的大脑中动脉血流速度评估。脑氧合和代谢从动脉到静脉的氧、葡萄糖和乳酸的差异进行评估。两组在运动期间的血压是相当的。然而，T2DM患者在高负荷下动脉二氧化碳分压较低，其工作能力和心输出量的增加仅为对照组的∽80%。T2DM患者运动时CBF和脑氧合降低（P < 0.05），表现出较高的运动感知等级（P < 0.05）。而对照组在运动过程中潜行脑流量增加了20%，两组大脑对乳酸和葡萄糖的吸收量基本一致。综上所述，这些结果表明，T2DM患者对运动的CBF和氧合反应受损可能与增加心输出量的能力有限和血管舒张能力降低有关，并可能导致他们高度感知运动。
Endothelial vascular function and capacity to increase cardiac output during exercise are impaired in patients with type 2 diabetes (T2DM). We tested the hypothesis that the increase in cerebral blood flow (CBF) during exercise is also blunted and, therefore, that cerebral oxygenation becomes affected and perceived exertion increased in T2DM patients. We quantified cerebrovascular besides systemic hemodynamic responses to incremental ergometer cycling exercise in eight male T2DM and seven control subjects. CBF was assessed from the Fick equation and by transcranial Doppler-determined middle cerebral artery blood flow velocity. Cerebral oxygenation and metabolism were evaluated from the arterial-to-venous differences for oxygen, glucose, and lactate. Blood pressure was comparable during exercise between the two groups. However, the partial pressure of arterial carbon dioxide was lower at higher workloads in T2DM patients and their work capacity and increase in cardiac output were only ∽80% of that established in the control subjects. CBF and cerebral oxygenation were reduced during exercise in T2DM patients (P < 0.05), and they expressed a higher rating of perceived exertion (P < 0.05). In contrast, CBF increased ∽20% during exercise in the control group while the brain uptake of lactate and glucose was similar in the two groups. In conclusion, these results suggest that impaired CBF and oxygenation responses to exercise in T2DM patients may relate to limited ability to increase cardiac output and to reduced vasodilatory capacity and could contribute to their high perceived exertion.