{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T06:57:12Z","timestamp":1777532232233,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006501","name":"Cystic Fibrosis Foundation Therapeutics","doi-asserted-by":"publisher","award":["Harris14A0"],"award-info":[{"award-number":["Harris14A0"]}],"id":[{"id":"10.13039\/100006501","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006501","name":"Cystic Fibrosis Foundation Therapeutics","doi-asserted-by":"publisher","award":["Harris19A0"],"award-info":[{"award-number":["Harris19A0"]}],"id":[{"id":"10.13039\/100006501","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R21DK100783"],"award-info":[{"award-number":["R21DK100783"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Chron Respir Dis"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Glycated hemoglobin can interfere with oxygen delivery and CO\n                      <jats:sub>2<\/jats:sub>\n                      removal during exercise. Additionally, pancreatic insufficiency increases oxidative stress and exacerbates exercise intolerance in people with cystic fibrosis (PwCF). This investigation sought to test the hypotheses that elevated Hemoglobin A\n                      <jats:sub>1c<\/jats:sub>\n                      (HbA\n                      <jats:sub>1c<\/jats:sub>\n                      ) can negatively affect exercise parameters in PwCF and that reductions in oxidative stress can improve tissue oxygenation in individuals with elevated HbA\n                      <jats:sub>1c<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Twenty four PwCF were divided into two groups; normal HbA1c &lt;5.7% (N-HbA\n                      <jats:sub>1c<\/jats:sub>\n                      ) and elevated HbA\n                      <jats:sub>1c<\/jats:sub>\n                      &gt;5.7% (E-HbA\n                      <jats:sub>1c<\/jats:sub>\n                      ). A maximal exercise test was conducted to obtain peak oxygen uptake (VO\n                      <jats:sub>2<\/jats:sub>\n                      peak), VO\n                      <jats:sub>2<\/jats:sub>\n                      at ventilatory threshold (VT), ventilatory parameters (V\n                      <jats:sub>E<\/jats:sub>\n                      \/VCO\n                      <jats:sub>2<\/jats:sub>\n                      slope and end-tidal CO\n                      <jats:sub>2<\/jats:sub>\n                      (petCO\n                      <jats:sub>2<\/jats:sub>\n                      )). Near-Infrared Spectroscopy (NIRS) was used to assess muscle oxygenated\/deoxygenated hemoglobin during exercise. A subset of individuals with E-HbA\n                      <jats:sub>1c<\/jats:sub>\n                      were given an antioxidant cocktail (AOC) for 4\u00a0weeks to determine the effects on tissue oxygenation during exercise.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A negative relationship between HbA\n                      <jats:sub>1c<\/jats:sub>\n                      and VO\n                      <jats:sub>2<\/jats:sub>\n                      peak at VT was observed (r = \u22120.511; p = 0.018). In addition, a positive relationship between HbA\n                      <jats:sub>1c<\/jats:sub>\n                      and V\n                      <jats:sub>E<\/jats:sub>\n                      \/VCO\n                      <jats:sub>2<\/jats:sub>\n                      slope ( r = 0.587; p = 0.005) and a negative relationship between HbA\n                      <jats:sub>1c<\/jats:sub>\n                      and petCO\n                      <jats:sub>2<\/jats:sub>\n                      at maximal exercise ( r = \u22120.472 ;p = 0.031) was observed. N-HbA\n                      <jats:sub>1c<\/jats:sub>\n                      had greater VO\n                      <jats:sub>2<\/jats:sub>\n                      peak ( p = 0.021), VO\n                      <jats:sub>2<\/jats:sub>\n                      at VT ( p = 0.004), petCO\n                      <jats:sub>2<\/jats:sub>\n                      ( p = 0.002), and lower V\n                      <jats:sub>E<\/jats:sub>\n                      \/VCO\n                      <jats:sub>2<\/jats:sub>\n                      slope ( p = 0.004) compared with E-HbA\n                      <jats:sub>1c<\/jats:sub>\n                      . Muscle deoxygenated hemoglobin at VT was higher in N-HbA\n                      <jats:sub>1c<\/jats:sub>\n                      vs. E-HbA\n                      <jats:sub>1c<\/jats:sub>\n                      and 4\u00a0weeks of AOC improved skeletal muscle utilization of oxygen.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings demonstrate that glycated hemoglobin may lead to tissue oxygenation impairment and ventilation inefficiency during exercise in PwCF. In addition, antioxidant supplementation may lead to improved tissue oxygenation during exercise.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14799731231174542","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T10:03:39Z","timestamp":1683799419000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Muscle oxygen utilization and ventilatory parameters during exercise in people with cystic fibrosis: Role of HbA\n                    <sub>1c<\/sub>"],"prefix":"10.1177","volume":"20","author":[{"given":"Brooke P","family":"Quertermous","sequence":"first","affiliation":[{"name":"Medical College of Georgia, Augusta University, Augusta, GA, USA"},{"name":"Laboratory of Integrative Vascular and Exercise Physiology, Georgia Prevention Institute, Department of Medicine, Augusta University, Augusta, GA, 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B","family":"Simon","sequence":"additional","affiliation":[{"name":"Medical College of Georgia, Augusta University, Augusta, GA, USA"},{"name":"Laboratory of Integrative Vascular and Exercise Physiology, Georgia Prevention Institute, Department of Medicine, Augusta University, Augusta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marsha","family":"Blackburn","sequence":"additional","affiliation":[{"name":"Laboratory of Integrative Vascular and Exercise Physiology, Georgia Prevention Institute, Department of Medicine, Augusta University, Augusta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassandra C","family":"Derella","sequence":"additional","affiliation":[{"name":"Laboratory of Integrative Vascular and Exercise Physiology, Georgia Prevention Institute, Department of Medicine, Augusta University, Augusta, GA, 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