Highlights
- •Obese patients present with normal cardiopulmonary exercise adaptation.
- •Metabolic syndrome does not impact cardiopulmonary exercise adaptation.
- •VO2peakBMI24 is a meaningful index of aerobic capacity.
Abstract
Background
Obesity might be a cause of limited aerobic exercise capacity. It is often associated
with metabolic syndrome (MS) that includes cardiovascular comorbidities as arterial
hypertension. Cardiopulmonary exercise testing (CPET) is the gold-standard to assess
aerobic capacity and discriminate causes of dyspnea.
Aim
To evaluate aerobic capacity in obesity and if MS or hypertensive treatment impacts
on the CPET profile.
Methods
CPET of 146 obese patients, whom 33 and 31 were matched for MS and antihypertensive
medication, were analyzed. VO2peak (mL/min/Kg) was reported in percentage of predicted value, or, divided by body weight,
fat free mass (FFM) or body weight expected for a body mass index of 24 (BMI24).
Results
VO2peak (20,8 ± 4,4 mL/min/Kg) was normal when expressed in percentage predicted for obesity
(111 ± 22%pred) or divided by FFM and weightBMI24 (33,6 ± 5,6 and 30,6 ± 6,2 respectively). The latter correlated better with maximal
work rate (r = 0,7168, p < 0,001). Obese patients showed normal ventilatory efficiency
(ventilation to carbon dioxide production slope: 28 ± 4), VO2 to work rate (10,2 ± 1,6 mLO2/Watt) and, slightly elevated heart rate to VO2 slope (4,0 ± 1,1 bpm/mL/min/Kg). Compared to normotensives, hypertensive medicated
patients had higher blood pressure at anaerobic threshold (142 ± 23 vs 158 ± 26 mmHg,
p = 0,001) but not at maximal exercise (189 ± 31 vs 201 ± 23 mmHg, p = NS), and, had
lower actual maximal heart rate (155 ± 23 vs 143 ± 25 bpm, p = 0,03). There was no
difference between obese patients with or without MS.
Conclusion
Obese people with or without MS present with similar and normal aerobic profile related
to the excessive body weight. VO2peak divided by weightBMI24 is an easy and clinical meaningful index for obese patients.
Keywords
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Article info
Publication history
Published online: February 27, 2023
Accepted:
February 25,
2023
Received in revised form:
February 24,
2023
Received:
November 15,
2022
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
