Cawood T J, McKenna M J, Gallagher C G, Smith D, Chung W Y, Gibney J, O'Shea D
Department of Endocrinology, St. Vincent's University Hospital, Dublin 4, Ireland.
Ir Med J. 2006 Mar;99(3):83-6.
We aimed to examine the differences between patients with cystic fibrosis-related diabetes (CFRD), and those with normal glucose handling in adults with cystic fibrosis (CF) in Ireland. We conducted a retrospective analysis of patients who attend the national referral centre for adult CF. Patients were diagnosed as having CFRD by the American Cystic Fibrosis Foundation criteria for diagnosis of CFRD. Of 259 patients, 150 were classifiable and 81 (54%) were classified as having CFRD. The groups with and without CFRD were not significantly different with regard to age (median 28.4 vs 26.0 years), sex (males 56% vs 55%) or BMI (median 20.9 vs 21.3 kg/m2). The group with CFRD had poorer lung function (mean % predicted FEV1 49.9 vs 66.4, P < 0.001), poorer bone mineral density (T-scores at the lumbar spine -1.95 vs -1.44, P < 0.05 and femur -1.19 vs -0.57, P < 0.01) and a greater proportion of PSEUDOMONAS AERUGINOSA positive sputum cultures (82.5% vs 64.2%, P < 0.05). No patients with CFRD carried the R1 17H mutation whilst 19% of the group without CFRD were heterozygous for this defect (P < 0.001). In conclusion, CFRD was highly prevalent in adults. The presence of CFRD was associated with poorer lung function, poorer bone mineral density and an increased prevalence of PSEUDOMONAS AERUGINOSA in sputum. The R1 17H mutation may be protective for CFRD.
我们旨在研究爱尔兰成年囊性纤维化(CF)患者中,患有囊性纤维化相关糖尿病(CFRD)的患者与血糖代谢正常的患者之间的差异。我们对就诊于国家成人CF转诊中心的患者进行了一项回顾性分析。根据美国囊性纤维化基金会的CFRD诊断标准,对患者进行CFRD诊断。在259例患者中,150例可分类,其中81例(54%)被分类为患有CFRD。患有和未患有CFRD的两组在年龄(中位数28.4岁 vs 26.0岁)、性别(男性56% vs 55%)或体重指数(中位数20.9 vs 21.3 kg/m²)方面无显著差异。患有CFRD的组肺功能较差(预计FEV1平均百分比49.9 vs 66.4,P < 0.001),骨矿物质密度较低(腰椎T值 -1.95 vs -1.44,P < 0.05;股骨 -1.19 vs -0.57,P < 0.01),且铜绿假单胞菌痰培养阳性的比例更高(82.5% vs 64.2%,P < 0.05)。没有CFRD的患者携带R117H突变,而在没有CFRD的组中,19%的患者对此缺陷为杂合子(P < 0.001)。总之,CFRD在成年人中非常普遍。CFRD的存在与较差的肺功能、较低的骨矿物质密度以及痰中铜绿假单胞菌患病率增加有关。R117H突变可能对CFRD具有保护作用。