Obese type 2 diabetics have a blunted hypotensive response to acute hyperthermia therapy that does not affect the perception of thermal stress or physiological strain compared to healthy adults

Eric Rivas, Dan E. Newmire, Vic Ben-Ezra

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2 Citations (Scopus)

Abstract

Purpose The objective of this study was to test the hypothesis that a hyperthermia-hypotensive challenge via whole body hot water immersion would alter the perception of hyperthermia and physiological strain in obese type 2 diabetics (T2DM) compared to healthy non-obese (HC) individuals. Additionally, we hypothesize that the mechanisms would be attributed to impaired blood pressure adjustments and afferent signals (via changes in internal and mean skin temperatures). Methods In random order, eleven obese T2DM (50 ± 12 y, 45 ± 7% fat mass, 7.5 ± 1.8% HbA1c) and nine similar aged (41 ± 14 y, P > 0.05) HC non-obese (33 ± 8% fat mass, P < 0.01) non-diabetic (5.3 ± 0.4% HbA1c, P < 0.01) underwent a 60 min bout of whole body passive hyperthermia followed by 60 min of recovery or a 2 h resting control condition. The perception of thermal sensation (TS, scale range: 1–13), calculated physiological strain (PSI), internal (Tre, rectal) and mean skin (Tsk) temperatures, heart rate (HR) and blood pressures (BP) were the primary dependent variables. Results Hyperthermia similarly increased Tre by 1.4 ± 0.4 °C, Tsk by 6.5 ± 0.8 °C and HR by 34 ± 8 bpm in both groups (P > 0.5). Hyperthermia reduced diastolic BP (27% in T2DM and 33% in HC, P < 0.05) and mean arterial BP (reduced by 15% in T2DM and by 19% in HC) relative to control conditions (P < 0.05). The reduction of mean arterial BP area under the curve was attenuated in T2DM (12%) compared to HC (30%) (group × condition, P < 0.01). TS and PSI during hyperthermia were not different between groups. Pearson product correlation reported strong correlations (r = 0.69–0.89) with Tre and Tsk with TS in both populations. The linear stepwise regression analysis revealed similar relative contributions for Tre (~ 60%) and Tsk (~ 40%) on TS for both groups. Conclusions These data indicate that obese T2DM with moderate metabolic control have an attenuated hyperthermia-hypotensive response that does not affect TS and PSI. This also may suggest behavioral thermoregulation is intact in this study group.

Original languageEnglish (US)
Pages (from-to)374-382
Number of pages9
JournalPhysiology and Behavior
Volume165
DOIs
StatePublished - Oct 15 2016

Fingerprint

Fever
Hot Temperature
Fats
Therapeutics
Social Adjustment
Skin Temperature
Body Water
Body Temperature Regulation
Immersion
Area Under Curve
Linear Models
Regression Analysis
Therapy
Fat
Blood Pressure
Population
Temperature
Water
Linear Regression

Keywords

  • Diabetes
  • Hyperthermia strain
  • Hypotension
  • Obesity
  • Perception
  • Thermal stress

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Philosophy
  • Behavioral Neuroscience

Cite this

@article{8b2db41b87004ff49ee44a62ff56b849,
title = "Obese type 2 diabetics have a blunted hypotensive response to acute hyperthermia therapy that does not affect the perception of thermal stress or physiological strain compared to healthy adults",
abstract = "Purpose The objective of this study was to test the hypothesis that a hyperthermia-hypotensive challenge via whole body hot water immersion would alter the perception of hyperthermia and physiological strain in obese type 2 diabetics (T2DM) compared to healthy non-obese (HC) individuals. Additionally, we hypothesize that the mechanisms would be attributed to impaired blood pressure adjustments and afferent signals (via changes in internal and mean skin temperatures). Methods In random order, eleven obese T2DM (50 ± 12 y, 45 ± 7{\%} fat mass, 7.5 ± 1.8{\%} HbA1c) and nine similar aged (41 ± 14 y, P > 0.05) HC non-obese (33 ± 8{\%} fat mass, P < 0.01) non-diabetic (5.3 ± 0.4{\%} HbA1c, P < 0.01) underwent a 60 min bout of whole body passive hyperthermia followed by 60 min of recovery or a 2 h resting control condition. The perception of thermal sensation (TS, scale range: 1–13), calculated physiological strain (PSI), internal (Tre, rectal) and mean skin (Tsk) temperatures, heart rate (HR) and blood pressures (BP) were the primary dependent variables. Results Hyperthermia similarly increased Tre by 1.4 ± 0.4 °C, Tsk by 6.5 ± 0.8 °C and HR by 34 ± 8 bpm in both groups (P > 0.5). Hyperthermia reduced diastolic BP (27{\%} in T2DM and 33{\%} in HC, P < 0.05) and mean arterial BP (reduced by 15{\%} in T2DM and by 19{\%} in HC) relative to control conditions (P < 0.05). The reduction of mean arterial BP area under the curve was attenuated in T2DM (12{\%}) compared to HC (30{\%}) (group × condition, P < 0.01). TS and PSI during hyperthermia were not different between groups. Pearson product correlation reported strong correlations (r = 0.69–0.89) with Tre and Tsk with TS in both populations. The linear stepwise regression analysis revealed similar relative contributions for Tre (~ 60{\%}) and Tsk (~ 40{\%}) on TS for both groups. Conclusions These data indicate that obese T2DM with moderate metabolic control have an attenuated hyperthermia-hypotensive response that does not affect TS and PSI. This also may suggest behavioral thermoregulation is intact in this study group.",
keywords = "Diabetes, Hyperthermia strain, Hypotension, Obesity, Perception, Thermal stress",
author = "Eric Rivas and Newmire, {Dan E.} and Vic Ben-Ezra",
year = "2016",
month = "10",
day = "15",
doi = "10.1016/j.physbeh.2016.08.026",
language = "English (US)",
volume = "165",
pages = "374--382",
journal = "Physiology and Behavior",
issn = "0031-9384",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Obese type 2 diabetics have a blunted hypotensive response to acute hyperthermia therapy that does not affect the perception of thermal stress or physiological strain compared to healthy adults

AU - Rivas, Eric

AU - Newmire, Dan E.

AU - Ben-Ezra, Vic

PY - 2016/10/15

Y1 - 2016/10/15

N2 - Purpose The objective of this study was to test the hypothesis that a hyperthermia-hypotensive challenge via whole body hot water immersion would alter the perception of hyperthermia and physiological strain in obese type 2 diabetics (T2DM) compared to healthy non-obese (HC) individuals. Additionally, we hypothesize that the mechanisms would be attributed to impaired blood pressure adjustments and afferent signals (via changes in internal and mean skin temperatures). Methods In random order, eleven obese T2DM (50 ± 12 y, 45 ± 7% fat mass, 7.5 ± 1.8% HbA1c) and nine similar aged (41 ± 14 y, P > 0.05) HC non-obese (33 ± 8% fat mass, P < 0.01) non-diabetic (5.3 ± 0.4% HbA1c, P < 0.01) underwent a 60 min bout of whole body passive hyperthermia followed by 60 min of recovery or a 2 h resting control condition. The perception of thermal sensation (TS, scale range: 1–13), calculated physiological strain (PSI), internal (Tre, rectal) and mean skin (Tsk) temperatures, heart rate (HR) and blood pressures (BP) were the primary dependent variables. Results Hyperthermia similarly increased Tre by 1.4 ± 0.4 °C, Tsk by 6.5 ± 0.8 °C and HR by 34 ± 8 bpm in both groups (P > 0.5). Hyperthermia reduced diastolic BP (27% in T2DM and 33% in HC, P < 0.05) and mean arterial BP (reduced by 15% in T2DM and by 19% in HC) relative to control conditions (P < 0.05). The reduction of mean arterial BP area under the curve was attenuated in T2DM (12%) compared to HC (30%) (group × condition, P < 0.01). TS and PSI during hyperthermia were not different between groups. Pearson product correlation reported strong correlations (r = 0.69–0.89) with Tre and Tsk with TS in both populations. The linear stepwise regression analysis revealed similar relative contributions for Tre (~ 60%) and Tsk (~ 40%) on TS for both groups. Conclusions These data indicate that obese T2DM with moderate metabolic control have an attenuated hyperthermia-hypotensive response that does not affect TS and PSI. This also may suggest behavioral thermoregulation is intact in this study group.

AB - Purpose The objective of this study was to test the hypothesis that a hyperthermia-hypotensive challenge via whole body hot water immersion would alter the perception of hyperthermia and physiological strain in obese type 2 diabetics (T2DM) compared to healthy non-obese (HC) individuals. Additionally, we hypothesize that the mechanisms would be attributed to impaired blood pressure adjustments and afferent signals (via changes in internal and mean skin temperatures). Methods In random order, eleven obese T2DM (50 ± 12 y, 45 ± 7% fat mass, 7.5 ± 1.8% HbA1c) and nine similar aged (41 ± 14 y, P > 0.05) HC non-obese (33 ± 8% fat mass, P < 0.01) non-diabetic (5.3 ± 0.4% HbA1c, P < 0.01) underwent a 60 min bout of whole body passive hyperthermia followed by 60 min of recovery or a 2 h resting control condition. The perception of thermal sensation (TS, scale range: 1–13), calculated physiological strain (PSI), internal (Tre, rectal) and mean skin (Tsk) temperatures, heart rate (HR) and blood pressures (BP) were the primary dependent variables. Results Hyperthermia similarly increased Tre by 1.4 ± 0.4 °C, Tsk by 6.5 ± 0.8 °C and HR by 34 ± 8 bpm in both groups (P > 0.5). Hyperthermia reduced diastolic BP (27% in T2DM and 33% in HC, P < 0.05) and mean arterial BP (reduced by 15% in T2DM and by 19% in HC) relative to control conditions (P < 0.05). The reduction of mean arterial BP area under the curve was attenuated in T2DM (12%) compared to HC (30%) (group × condition, P < 0.01). TS and PSI during hyperthermia were not different between groups. Pearson product correlation reported strong correlations (r = 0.69–0.89) with Tre and Tsk with TS in both populations. The linear stepwise regression analysis revealed similar relative contributions for Tre (~ 60%) and Tsk (~ 40%) on TS for both groups. Conclusions These data indicate that obese T2DM with moderate metabolic control have an attenuated hyperthermia-hypotensive response that does not affect TS and PSI. This also may suggest behavioral thermoregulation is intact in this study group.

KW - Diabetes

KW - Hyperthermia strain

KW - Hypotension

KW - Obesity

KW - Perception

KW - Thermal stress

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U2 - 10.1016/j.physbeh.2016.08.026

DO - 10.1016/j.physbeh.2016.08.026

M3 - Article

C2 - 27570191

AN - SCOPUS:84983747341

VL - 165

SP - 374

EP - 382

JO - Physiology and Behavior

JF - Physiology and Behavior

SN - 0031-9384

ER -