Pulmonary vascular control at moderate altitude in patients with type 1 diabetes

1型糖尿病患者中等海拔条件下的肺血管控制

基本信息

批准号：
7879215
负责人：
J Richard Coast
金额：
$ 19.91万
依托单位：
NORTHERN ARIZONA UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-04-13 至 2013-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7879215
关键词：
Acclimatization Activities of Daily Living Acute Address Adult Affect Air Altitude Alveolar American Arizona Arts Attenuated Award Biomedical Research Blood Blood Vessels Blood Volume Blood capillaries Carbon Monoxide Cardiac Output Child Chronic Clinical Collaborations Coupled Data Diabetes Mellitus Diffuse Diffusion Environment Equipment Exercise Exertion Exposure to Funding Future Gases Goals Grant Health Human Characteristics Impairment Individual Insulin-Dependent Diabetes Mellitus Laboratories Life Lung Lung Capacity Measures Membrane Oxygen Patients Performance Pharmacy facility Physical activity Physiology Policies Population Prevalence Protocols documentation Pulmonary Diffusing Capacity Reporting Research Research Design Respiratory physiology Rest Sea Skiing Students Translating Universities attenuation base capillary college diabetic diabetic patient experience falls glycemic control graduate student improved indexing mass spectrometer medical schools meter non-diabetic oxygen transport prevent programs public health relevance response success type I diabetic

项目摘要

DESCRIPTION (provided by applicant): An increasing number of people type 1 diabetes are participating in adventure activities at moderate or high altitude. Limited data suggests that diabetic individuals may be less 'successful' in these conditions. While rarely an issue at sea level, lung diffusing capacity can be a limiting factor for oxygen transport during exercise at increased altitude. In diabetics, this limitation may be exacerbated by impaired pulmonary diffusion which often goes unnoticed at sea level. The cause of diabetic pulmonary diffusion limitation is unclear, and may involve alveolar membrane diffusing capacity (DM) or pulmonary capillary blood volume (Vc). When exposed to the combination of exercise and increased altitude diabetic patients may experience arterial desaturation, which lowers functional capacity and may increase the prevalence of altitude illness. This study will use two parallel laboratories to measure diffusing capacity at low and moderate altitude (2150 meters) in type 1 diabetic and non-diabetic subjects who live at low altitude. By measuring multiple expired gases with a mass spectrometer (in both labs), we will partition out the influence of DM and Vc to determine which of these factors, if any, reduces pulmonary diffusion in diabetic subjects exercising at moderate altitude. An additional group of type 1 diabetic patients who live at moderate altitude will be studied to determine if diffusion limitation is attenuated or reversed by chronic moderate altitude exposure. Based on the findings of these studies, future research will determine whether aggressive glycemic control, which prevents the normal decline in pulmonary diffusing capacity in type 1 diabetics at sea level, will improve pulmonary diffusion and performance during acute moderate altitude exposure. PUBLIC HEALTH RELEVANCE: The diabetic lung is less capable of delivering oxygen from the air into the blood. This condition often goes unnoticed at low altitude where oxygen availability is high, however impaired lung function can have serious health consequences during physical exertion at increased altitude. The results of this study will determine whether impaired lung function limits people with diabetes from participating in high altitude activities, and provide a starting point for research designed to improve lung function.

描述（由申请人提供）：越来越多的 1 型糖尿病患者参加中海拔或高海拔的冒险活动。有限的数据表明，糖尿病患者在这些情况下可能不太“成功”。虽然在海平面很少出现问题，但肺扩散能力可能是高海拔运动期间氧气输送的限制因素。对于糖尿病患者来说，这种限制可能会因肺扩散受损而加剧，而肺扩散受损在海平面上常常被忽视。糖尿病肺弥散受限的原因尚不清楚，可能与肺泡膜弥散能力（DM）或肺毛细血管血容量（Vc）有关。当运动和海拔升高相结合时，糖尿病患者可能会经历动脉饱和度降低，从而降低功能能力并可能增加高原病的患病率。这项研究将使用两个平行实验室来测量居住在低海拔地区的 1 型糖尿病和非糖尿病受试者在低海拔和中海拔（2150 米）下的扩散能力。通过使用质谱仪（在两个实验室中）测量多种呼出气体，我们将划分 DM 和 Vc 的影响，以确定这些因素中的哪一个（如果有）会减少在中等海拔运动的糖尿病受试者的肺扩散。另外一组居住在中等海拔地区的 1 型糖尿病患者将被研究，以确定长期暴露在中等海拔地区是否会减弱或逆转扩散限制。基于这些研究的结果，未来的研究将确定积极的血糖控制是否会改善急性中等海拔暴露期间的肺扩散和性能，积极的血糖控制可以防止海平面1型糖尿病患者肺弥散能力的正常下降。公众健康相关性：糖尿病患者的肺将空气中的氧气输送到血液中的能力较差。在氧气供应量较高的低海拔地区，这种情况常常被忽视，但在海拔较高的体力消耗过程中，肺功能受损可能会产生严重的健康后果。这项研究的结果将确定肺功能受损是否会限制糖尿病患者参加高海拔活动，并为旨在改善肺功能的研究提供起点。