Moreau F, Weiller M A, Rosner V, Weiss L, Hasselmann M, Pinget M, Kessler R, Kessler L
Department of Endocrinology and Diabetology, University Hospital, Strasbourg, France.
Horm Metab Res. 2008 Jul;40(7):502-6. doi: 10.1055/s-2008-1062723. Epub 2008 Apr 14.
Cystic fibrosis (CF) is associated with a long preclinical state of abnormal glucose tolerance. The aim of this study was (i) to evaluate the profile of glucose tolerance in young adults with CF and (ii) to compare these results with those obtained by a continuous subcutaneous glucose monitoring (CGMS). CF subjects with fasting glycemia inferior to 126 mg/dl were included in the study. An oral glucose tolerance test (OGTT) identified the subjects either with a normal glucose tolerance (NGT), or impaired glucose tolerance (IGT), or diabetes. CGMS (Medtronic) was performed during 3 days to analyze mean glucose level, high glucose excursions, and glucose area under the curve (AUC). Forty-nine patients were included in the study. NGT (n=22), IGT (n=17), and diabetes groups (n=10) were comparable except with regard to age and BMI (p<0.001). HbA1c values in diabetes group were significantly higher (p<0.001) than in NGT and IGT groups. CGMS revealed peaks of glucose values superior to 200 mg/dl at least once after a meal in 8 patients (36%) with NGT, in 9 patients (52%) with IGT, and in all patients with diabetes (p<0.01). Mean CGMS glucose and glucose AUC values increased in patients with diabetes compared to patients with NGT and IGT (p<0.05). Peak of CGMS glucose reached 182+/-60 mg/dl in NGT group despite the normal glucose profile at OGTT. In conclusion, CGMS revealed pathological glucose excursions not only in patients with impaired glucose tolerance at OGTT but also in patients with a normal glycemic profile. CGMS could be a useful tool for the early detection of hyperglycemia in patients with CF.
囊性纤维化（CF）与糖耐异常的长期临床前期状态相关。本研究的目的是：（i）评估年轻CF患者的糖耐情况；（ii）将这些结果与通过连续皮下葡萄糖监测（CGMS）获得的结果进行比较。空腹血糖低于126 mg/dl的CF受试者被纳入研究。口服葡萄糖耐量试验（OGTT）确定受试者是糖耐正常（NGT）、糖耐受损（IGT）还是患有糖尿病。进行3天的CGMS（美敦力）以分析平均血糖水平、高血糖波动以及血糖曲线下面积（AUC）。49例患者被纳入研究。NGT组（n = 22）、IGT组（n = 17）和糖尿病组（n = 10）除年龄和BMI外具有可比性（p < 0.001）。糖尿病组的糖化血红蛋白（HbA1c）值显著高于NGT组和IGT组（p < 0.001）。CGMS显示，在NGT组的8例患者（36%）、IGT组的9例患者（52%）以及所有糖尿病患者中，至少有一次餐后血糖值峰值超过200 mg/dl（p < 0.01）。与NGT组和IGT组患者相比，糖尿病患者的CGMS平均血糖和血糖AUC值升高（p < 0.05）。尽管OGTT时血糖情况正常，但NGT组的CGMS血糖峰值达到182±60 mg/dl。总之，CGMS不仅在OGTT糖耐受损的患者中，而且在血糖情况正常的患者中均显示出病理性血糖波动。CGMS可能是早期检测CF患者高血糖的有用工具。
