Dose–response effect of pre-exercise carbohydrates under muscle glycogen unavailability: Insights from McArdle disease

Background This study aimed to determine the effect of different carbohydrate (CHO) doses on exercise capacity in patients with McArdle disease—the paradigm of “exercise intolerance”, characterized by complete muscle glycogen unavailability—and to determine whether higher exogenous glucose levels af...

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Detalles Bibliográficos
Autores: Valenzuela Tallón, Pedro Luis, Santalla Hernández, Alfredo, Brea Alejo, Lidia, Merlo, Andrea, Bustos, Asunción, Castellote Bellés, Laura, Ferrer Costa, Roser, Maffiuletti, Nicola A., Barranco Gil, David, Pinós, Tomás, Lucía Mulas, Alejandro
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universidad Europea (UEM)
Repositorio:ABACUS. Repositorio de Producción Científica
Idioma:inglés
OAI Identifier:oai:abacus.universidadeuropea.com:11268/12399
Acceso en línea:http://hdl.handle.net/11268/12399
Access Level:acceso abierto
Palabra clave:Suplementos dietéticos
Enfermedad del almacenamiento de glucógeno
Nutrición
Efectos fisiológicos
Metabolismo
Goal 3: Ensure healthy lives and promote well-being for all at all ages
Descripción
Sumario:Background This study aimed to determine the effect of different carbohydrate (CHO) doses on exercise capacity in patients with McArdle disease—the paradigm of “exercise intolerance”, characterized by complete muscle glycogen unavailability—and to determine whether higher exogenous glucose levels affect metabolic responses at the McArdle muscle cell (in vitro) level. Methods Patients with McArdle disease (n = 8) and healthy controls (n = 9) underwent a 12-min submaximal cycling constant-load bout followed by a maximal ramp test 15 min after ingesting a non-caloric placebo. In a randomized, double-blinded, cross-over design, patients repeated the tests after consuming either 75 g or 150 g of CHO (glucose:fructose, 2:1). Cardiorespiratory, biochemical, perceptual, and electromyographic (EMG) variables were assessed. Additionally, glucose uptake and lactate appearance were studied in vitro in wild-type and McArdle mouse myotubes cultured with increasing glucose concentrations (0.35, 1.00, 4.50, and 10.00 g/L). Results Compared with controls, patients showed the “classical” second-wind phenomenon (after prior disproportionate tachycardia, myalgia, and excess EMG activity during submaximal exercise, all p < 0.05) and an impaired endurance exercise capacity (–51% ventilatory threshold (VT) and –55% peak power output (PPO), both p < 0.001). Regardless of the CHO dose (p < 0.05 for both doses compared with the placebo), CHO intake increased blood glucose and lactate levels, decreased fat oxidation rates, and attenuated the second wind in the patients. However, only the higher dose increased VT (+27%, p = 0.010) and PPO (+18%, p = 0.007). In vitro analyses revealed no differences in lactate levels across glucose concentrations in wild-type myotubes, whereas a dose–response effect was observed in McArdle myotubes. Conclusion CHO intake exerts beneficial effects on exercise capacity in McArdle disease, a condition associated with total muscle glycogen unavailability. Some of these benefits were dose-dependent.