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. 2022 Mar 30:13:834664.
doi: 10.3389/fphys.2022.834664. eCollection 2022.

The Effect of Dysglycaemia on Changes in Pulmonary and Aerobic Function in Cystic Fibrosis

Owen W Tomlinson  1   2 , Anna L E Stoate  1 , Lee Dobson  2 , Craig A Williams  1   2
Affiliations

The Effect of Dysglycaemia on Changes in Pulmonary and Aerobic Function in Cystic Fibrosis

Owen W Tomlinson et al. Front Physiol. .

Abstract

Cross-sectional studies have reported lower pulmonary and aerobic function during exercise in people with cystic fibrosis-related diabetes (CFRD) compared to non-CFRD counterparts. However, this association has yet to be longitudinally investigated. Therefore, this study examines these differences over time between people with cystic fibrosis (CF) of differing glycaemic status. Annual review data, including cardiopulmonary exercise tests and pulmonary function tests, were retrospectively analysed at baseline (T0, n = 82) and at a one-year follow-up (T1, n = 54). Data was analysed in three groups: normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and CFRD. Further analyses were undertaken, with a dichotomous split of NGT and a combined IGT/CFRD group. At baseline, a significant reduction in the majority of variables, including forced expiratory volume in one second (FEV1) and maximal oxygen uptake (VO2max), was observed in the CFRD (n = 19) group compared to NGT (n = 58). At follow-up, no significant differences were observed, and no interaction effect between CFRD status and time was identified. FEV1 and VO2max presented with varying directions and magnitudes of change within patients. In summary, patients with CFRD have a reduced aerobic and pulmonary function compared to non-CFRD counterparts, although such changes disappeared at follow up. Varying responses for FEV1 and VO2max highlight the need to consider both variables as independent markers of function in CF.

Keywords: cardiorespiratory fitness; cystic fibrosis related diabetes; longitudinal data; oxygen uptake; pulmonary disease.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram, characterising follow-up and drop-out of participants, split by glycaemic status in three groups (CFRD, IGT, NGT), and when considered dichotomously (IGT/CFRD, NGT) at baseline and one-year follow-up. CFRD: cystic fibrosis related diabetes; IGT: impaired glucose tolerance; NGT: normal glucose tolerance; T0: baseline measurement; T1: 1 year follow-up; VO2max: maximal oxygen uptake.
FIGURE 2
FIGURE 2
Comparison of FEV1 (%Pred) and VO2max in groups of differing glycaemic status at baseline (T0) and at one-year follow up (T1). CFRD: cystic fibrosis related diabetes; IGT: impaired glucose tolerance; NGT: normal glucose tolerance. FEV1: forced expiratory volume in 1 s as a percentage of predicted; VO2max: maximal oxygen uptake. P-values are derived from post hoc tests following one-way ANOVA (a), and repeated measures ANOVA (b).
FIGURE 3
FIGURE 3
The relationship between the annual change (Δ) in FEV1 and VO2max for 54 patients with CF. Crosses (×) indicate combined IGT/CFRD group, circles (°) indicate NGT group. FEV1: forced expiratory volume in 1 s; VO2max: maximal oxygen uptake. All data is presented as T1-T0 (i.e., a negative number indicates a decrease in function over the course of 1 year).
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