Gut related inflammation and cardiorespiratory fitness in patients with CAD and type 2 diabetes: a sub-study of a randomized controlled trial on exercise training

Susanne Kristine Aune, Rune Byrkjeland, Svein Solheim, Harald Arnesen, Marius Trøseid, Ayodeji Awoyemi, Ingebjørg Seljeflot, Ragnhild Helseth, Susanne Kristine Aune, Rune Byrkjeland, Svein Solheim, Harald Arnesen, Marius Trøseid, Ayodeji Awoyemi, Ingebjørg Seljeflot, Ragnhild Helseth

Abstract

Aim: Gut leakage has been shown to associate with low-grade inflammation and lower cardiorespiratory fitness in diabetic subjects. We aimed to investigate whether gut leakage markers related to cardiorespiratory fitness in patients with both coronary artery disease and type 2 diabetes, and whether these were affected by long-term exercise training.

Methods: Patients with angiographically verified coronary artery disease and type 2 diabetes mellitus (n = 137) were randomized to either 12 months exercise intervention or conventional follow-up. A cardiopulmonary exercise test and fasting blood samples were obtained before and after intervention to assess VO2peak and the biomarkers soluble CD14, lipopolysaccharide-binding protein and intestinal fatty-acid binding protein as markers of gut leakage.

Results: 114 patients completed the intervention satisfactory. VO2peak correlated inversely to sCD14 (r = - 0.248, p = 0.004) at baseline. Dividing sCD14 into quartiles (Q), VO2peak was significantly higher in Q1 vs. Q2-4 (p = 0.001), and patients in Q2-4 (sCD14 > 1300 ng/mL) had an OR of 2.9 (95% CI 1.2-7.0) of having VO2peak below median (< 23.8 ml/kg/min) at baseline. There were no statistically significant differences in changes in gut leakage markers between the two randomized groups (all p > 0.05) after 12 months.

Conclusions: Cardiorespiratory fitness related inversely to sCD14, suggesting physical capacity to be associated with gut leakage in patients with CAD and T2DM. Long-term exercise training did not affect circulating gut leakage markers in our population. Trial registration NCT01232608, Registered 02 November 2010-Retrospectively registered at https://ichgcp.net/clinical-trials-registry/NCT01232608?term=NCT01232608&draw=2&rank=1.

Keywords: Cardiovascular fitness; Coronary artery disease; Exercise intervention; Gut leakage; Inflammation; Type 2 diabetes.

Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
VO2peak in quartiles of sCD14. Q1: < 1300 ng/mL Q2: 1300–1504 ng/mL Q3: 1504–1759 ng/mL Q4: > 1759 ng/mL (error bars indicate 25th, 75th percentiles). Arrow indicates cut off level
Fig. 2
Fig. 2
VO2peak in dichotomized groups of sCD14 (error bars indicate 25th, 75th percentiles). p-value is given for difference between groups
Fig. 3
Fig. 3
Median changes in gut leakage markers from baseline to 12 months in the randomized groups in absolute values (error bars indicate 25th, 75th percentiles). ∆p-values refer to difference in change between groups
Fig. 4
Fig. 4
Relative changes in gut leakage markers from baseline to 12 months in the randomized groups. The relative changes are presented as median (error bars indicate 25th, 75th percentiles). Rel ∆p-values refer to difference in change between groups

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Source: PubMed

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