| Description | Project Summary
Low cardiorespiratory fitness (CRF) is linked to high risks of cardiovascular disease (CVD), all-cause mortality, and mortality rates across various demographics. Studies show CRF is a stronger mortality predictor than traditional CVD risk factors and can enhance risk assessment for adverse outcomes. Despite its importance, CRF testing is rarely used in clinical practice, especially for type 1 diabetes (T1D) patients, who face a high CVD risk and premature mortality.
Though previous research by this group indicates lower exercise tolerance in T1D patients compared to healthy individuals, large-scale assessments of CRF and its link to CVD risk in diverse T1D populations are lacking. Current knowledge on the role of physical activity in CVD management and/or prevention mainly comes from self-reported physical activity questionnaires with limited exploration of underlying physiological mechanisms.
This project aims to use a comprehensive approach, analysing existing, prospective, and interventional data from a large T1D cohort. It will involve the analysis of retrospectively collected data from over 200 individuals with type 1 diabetes (T1D) across various ages, fitness levels, glycemic control, diabetes complications, genders, and races, in which identical CRF test protocols were used. This will create the first T1D-specific pooled data set of CRF test metrics alongside concurrently collected traditional (via registry databases) and novel (via biobank analytes) CVD risk biomarkers including diabetes characteristics, medical history, lifestyle habits, and anthropometry. The data will be correlated with the STENO risk engine to generate 5- and 10-year CVD risk predictions, creating the first T1D-specific data bank.
Aim: To establish a comprehensive understanding of the relationship between cardiorespiratory fitness (CRF) and cardiovascular disease (CVD) risk in individuals with type 1 diabetes (T1D) by creating the first T1D-specific pooled data set of CRF metrics and CVD risk biomarkers.
Objectives: To utilise retrospectively collected data from over 200 T1D individuals across various demographics and health statuses. To evaluate CRF using identical test protocols and correlate results with traditional and novel CVD risk biomarkers. To use the STENO risk engine to produce 5- and 10-year CVD risk predictions based on CRF classifications. To enhance understanding of exercise tolerance in T1D patients to inform targeted, personalized health interventions. |
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| Preparation | Preparatory readings.
(1) American Thoracic Society/American College of Chest Physicians Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003;167(2):211-277. doi:10.1164/rccm.167.2.211
(2) Hägglund H, Uusitalo A, Peltonen JE, et al. Cardiovascular autonomic nervous system function and aerobic capacity in type 1 diabetes. Front Physiol. 2012;3. doi:10.3389/FPHYS.2012.00356
(3) Metabolic and cardiovascular response to exercise in patients with type 1 diabetes. J Endocrinol Invest. 2017;40(9):999-1005. doi:10.1007/s40618-017-0670-6
(4) Levett DZH, Jack S, Swart M, et al. Perioperative cardiopulmonary exercise testing (CPET): consensus clinical guidelines on indications, organization, conduct, and physiological interpretation. Br J Anaesth. 2018;120(3):484-500. doi:10.1016/j.bja.2017.10.020
(5) Stubbe B, Schipf S, Schäper C, et al. The Influence of Type 1 Diabetes Mellitus on Pulmonary Function and Exercise Capacity - Results from the Study of Health in Pomerania (SHIP). Exp Clin Endocrinol Diabetes. 2017;125(1):64-69. doi:10.1055/S-0042-112219 |
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