MEDICAL AREA   

Medicina dello Sport 2019 September;72(3):374-84

DOI: 10.23736/S0025-7826.19.03484-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Effects of aerobic training on the risk of coronary artery disease by Duke Treadmill Score in type 2 diabetes mellitus and cardiometabolic health

Divna TREBINJAC ¹ ✉, Ivana PETRONIC ^{2, 3}, Nebojsa LALIC ^{3, 4}, Dragana CIROVIC ^{2, 3}, Dejan NIKOLIC ^{2, 3}, Jasna STOJKOVIC ^{2, 3}

¹ Department of Cardiac Rehabilitation, LHL Hospital Gardermoen, Jessheim, Norway; ² Department of Physical Medicine and Rehabilitation, University Children’s Hospital, Belgrade, Serbia; ³ Faculty of Medicine, University of Belgrade, Belgrade, Serbia; ⁴ Clinical Center of Serbia, Belgrade, Serbia

BACKGROUND: We aimed to investigate the impact of eight-week aerobic exercise training on the risk of coronary heart disease onset by Duke Treadmill Score (DTS), metabolic equivalent of task (MET), and metabolic syndrome parameters, as well as correlation between those parameters in patients with type 2 diabetes mellitus. There is the clinical value of DTS for the risk stratification as well as strong association between DTS and the combined outcomes of cardiac death, nonfatal myocardial infarction, congestive heart failure and revascularization.
METHODS: Sixty patients in stable clinical condition and well-regulated diabetic status conducted all phases of the study. Participants performed treadmill exercise testing using standard Bruce protocol before and after study. Rate of perceived exertion (RPE), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose levels (GLU), waist circumference (WC), triglyceride levels (TRI), high-sensitivity C-reactive protein (hs-CRP), probability of 5-year mortality (P5YM), probability of significant coronary heart disease (pCHD), probability of severe coronary disease (sCHD), DTS and METs levels were evaluated before and after study as well as correlation between DTS, METs and other parameters.
RESULTS: The average values of DTS of 4.67 obtained before study indicated a moderate risk for CHD, while average values of 5.61 obtained after study indicated a low risk for CHD. Linear regression model stressed that variable DTS is statistically significant predictor, where higher values of DTS leads to the higher score values of METs. There is statistically significant difference in METs (P<0.001), RPE (P<0.001), sCHD (P=0.038), P5YM (P=0.033) values after study.
CONCLUSIONS: Our study suggests that eight-week aerobic exercise training could significantly reduce the risk stratification by DTS from the intermediate to the moderate risk group for coronary heart disease in patients with type 2 diabetes mellitus. Lower values of DTS in women obtained in our research should be investigated in the future studies. Additionally, we have shown that increasing in METs will ultimately bring to decreased mortality in participants with diabetes mellitus type 2 and could significantly improve cardio-metabolic health that indicates the enormous potential value of exercise training.

KEY WORDS: Type 2 diabetes mellitus; Exercise test; Metabolic syndrome; Anaerobic threshold