Abstract 3533: Cardiorespiratory Fitness Is Inversely Associated With Inflammatory And Fibrinolytic Markers In Patients With Type 2 Diabetes
Objective: Type 2 diabetes is associated with an increased risk for cardiovascular disease. Higher levels of cardiorespiratory fitness (CRF) reduce risk of cardiovascular morbidity and mortality in type 2 diabetes. Elevated inflammatory markers and impaired fibrinolysis are associated with increased cardiovascular risk. We hypothesized that higher levels of cardiorespiratory fitness may be associated with lower levels of inflammatory and fibrinolytic markers in patients with type 2 diabetes.
Methods: 425 (mean age 54.6 ± 7.8 yrs) asymptomatic men with type 2 diabetes (defined as a fasting glucose ≥126mg/dl or self-reported use of an oral hypoglycemic agent) who participated in a medical checkup program underwent analysis of fasting blood for inflammatory markers, lipid profiles, and fibrinolytic factors. CRF was measured by peak oxygen uptake using expired gas analysis during a symptom-limited graded treadmill exercise test.
Results: CRF was significantly correlated with age (r=−0.51, p<0.05), body mass index (BMI) (r=−0.19, p<0.05), C-reactive protein (CRP) (r=−0.26, p<0.05), white blood cell (WBC) (r=−0.13, p<0.05), fibrinogen (r=−0.28, p<0.05), lipoprotein (a) (r=−0.47, p<0.05), tissue plasminogen activator (t-PA) antigen (r=−0.65, p<0.05), and albumin (r=0.26, p<0.05), but not plasminogen activator inhibitor 1 activity. Men in the highest quartile of CRF had a significantly lower CRP, WBC, fibrinogen, lipoprotein (a), and t-PA than men in the lowest quartile of CRF (all P trend <0.05). In separate multivariable linear regression models that adjusted for age, BMI, smoking, lipid profiles, glucose and systolic blood pressure, CRP (β= −0.29, p<0.05), WBC (β= −0.25, p<0.05), fibrinogen (β= −0.25, p<0.05), albumin (β= 0.19, p<0.05), lipoprotein (a) (β= −0.36, p<0.05) and t-PA (β= −0.68, p=0.05) were each inversely associated with CRF.
Conclusions: These results suggest that higher levels of cardiorespiratory fitness are inversely associated with inflammatory markers and fibrinolytic factors in patients with type 2 diabetes.