AIMS/HYPOTHESIS The aim of this study was to compare exercise capacity, strength and skeletal muscle perfusion during exercise, and oxidative capacity between South Asians, African Caribbeans and Europeans, and determine what effect ethnic differences in the prevalence of type 2 diabetes has on these functional outcomes. METHODS In total, 708 participants (aged [mean±SD] 73 ± 7 years, 56% male) were recruited from the Southall and Brent Revisited (SABRE) study, a UK population-based cohort comprised of Europeans (n = 311) and South Asian (n = 232) and African Caribbean (n = 165) migrants. Measurements of exercise capacity using a 6 min stepper test (6MST), including measurement of oxygen consumption ([Formula: see text]) and grip strength, were performed. Skeletal muscle was assessed using near infrared spectroscopy (NIRS); measures included changes in tissue saturation index (∆TSI%) with exercise and oxidative capacity (muscle oxygen consumption recovery, represented by a time constant [τ]). Analysis was by multiple linear regression. RESULTS When adjusted for age and sex, in South Asians and African Caribbeans, exercise capacity was reduced compared with Europeans ([Formula: see text] [ml min-1 kg-1]: β = -1.2 [95% CI -1.9, -0.4], p = 0.002, and β -1.7 [95% CI -2.5, -0.8], p < 0.001, respectively). South Asians had lower and African Caribbeans had higher strength compared with Europeans (strength [kPa]: β = -9 [95% CI -12, -6), p < 0.001, and β = 6 [95% CI 3, 9], p < 0.001, respectively). South Asians had greater decreases in TSI% and longer τ compared with Europeans (∆TSI% [%]: β = -0.9 [95% CI -1.7, -0.1), p = 0.024; τ [s]: β = 11 [95% CI 3, 18], p = 0.006). Ethnic differences in [Formula: see text] and grip strength remained despite adjustment for type 2 diabetes or HbA1c (and fat-free mass for grip strength). However, the differences between Europeans and South Asians were no longer statistically significant after adjustment for other possible mediators or confounders (including physical activity, waist-to-hip ratio, cardiovascular disease or hypertension, smoking, haemoglobin levels or β-blocker use). The difference in ∆TSI% between Europeans and South Asians was marginally attenuated after adjustment for type 2 diabetes or HbA1c and was also no longer statistically significant after adjusting for other confounders; however, τ remained significantly longer in South Asians vs Europeans despite adjustment for all confounders. CONCLUSIONS/INTERPRETATION Reduced exercise capacity in South Asians and African Caribbeans is unexplained by higher rates of type 2 diabetes. Poorer exercise tolerance in these populations, and impaired muscle function and perfusion in South Asians, may contribute to the higher morbidity burden of UK ethnic minority groups in older age.

中文翻译：

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2型糖尿病不能解决老年人运动能力或骨骼肌功能的种族差异。

目的/假设这项研究的目的是比较运动能力，力量和骨骼肌在运动过程中的灌注以及南亚人，非洲加勒比海人和欧洲人之间的氧化能力，并确定2型糖尿病患病率的种族差异对此有何影响功能结果。方法共有708名参与者（平均年龄[±SD] 73±7岁，男性56％）从Southall和Brent Revisited（SABRE）研究中招募，该研究是由欧洲人组成的英国人群（n = 311）和南亚（n = 232）和非洲加勒比海（n = 165）移民。使用6分钟的步进测试（6MST）进行运动能力的测量，包括氧气消耗（[公式：参见文本]）和握力的测量。使用近红外光谱（NIRS）评估骨骼肌；措施包括随着运动和氧化能力（肌肉耗氧量恢复，由时间常数[τ]表示）的组织饱和指数（∆TSI％）的变化。通过多元线性回归进行分析。结果在调整了年龄和性别后，在南亚人和非洲加勒比海地区，运动能力与欧洲人相比有所降低（[公式：请参见文本] [ml min-1 kg-1]：β= -1.2 [95％CI -1.9， -0.4]，p = 0.002和β-1.7 [95％CI -2.5，-0.8]，p <0.001）。与欧洲人相比，南亚人的强度较低，而非洲加勒比海的强度较高（强度[kPa]：β= -9 [95％CI -12，-6），p <0.001，β= 6 [95％CI 3，9] ，分别为p <0.001）。与欧洲人相比，南亚人的TSI％下降幅度更大，τ更长（∆TSI％[％]：β= -0.9 [95％CI -1.7，-0.1]，p = 0.024；τ[s]：β= 11 [95％CI 3，18]，p = 0。006）。尽管对2型糖尿病或HbA1c（以及无脂肪量的抓地力）进行了调整，但[公式：请参见文本]中的种族差异和抓地力仍然存在。但是，在调整其他可能的介体或混杂因素（包括体育锻炼，腰臀比率，心血管疾病或高血压，吸烟，血红蛋白水平或使用β受体阻滞剂）后，欧洲人和南亚人之间的差异不再具有统计学意义。在调整了2型糖尿病或HbA1c之后，欧洲人和南亚人之间的∆TSI％差异有所减弱，并且在调整了其他混杂因素后，差异也不再具有统计学意义。然而，尽管对所有混杂因素进行了调整，但南亚人与欧洲人的τ仍然明显更长。结论/解释由于2型糖尿病的患病率较高，无法解释南亚人和非洲加勒比海地区运动能力的下降。这些人群的运动耐力较差，南亚人的肌肉功能和灌注受损，可能会导致英国少数民族老年人的发病率增加。