De Schepper J, Dab I, Derde M P, Loeb H
Department of Paediatrics, Akademisch Ziekenhuis Vrije Universiteit Brussel, Belgium.
Eur J Pediatr. 1991 Apr;150(6):403-6. doi: 10.1007/BF02093718.
In 48 patients (age 2-28 years) with documented cystic fibrosis, glucose tolerance was evaluated by means of an oral glucose tolerance test (OGTT) and repeated glycosylated haemoglobin (HbA1C) measurements. An impaired OGTT was found in 15 patients. Their degree of undernutrition and severity of lung and liver involvement were no different from those with normal glucose tolerance. The mean peak insulin concentration as well as the integrated insulin concentration during the OGTT were comparable with patients with normal glucose tolerance (GT) and those with an impaired tolerance (GI). The mean time to attain peak insulin levels was significantly delayed in the GI group. (117 min vs 86 min P less than 0.01). On initial testing, elevated HbA1C levels were found in 22 patients. Mean HbA1C levels in the GI group were higher than in the GT group (8.2% vs 7.5% P less than 0.01). The HbA1C levels at the moment of OGT testing were positively correlated with the glycaemic response during the OGTT. The repeated HbA1C measurements 1 year later were no different from the initial mean HbA1C values in both groups. Two GI patients with initial HbA1C levels of 7.5% and 11% respectively developed diabetes mellitus several months after testing. The need for serial HbA1C determinations in cystic fibrosis is questioned.
在48例（年龄2 - 28岁）确诊为囊性纤维化的患者中，通过口服葡萄糖耐量试验（OGTT）和重复测定糖化血红蛋白（HbA1C）来评估葡萄糖耐量。15例患者OGTT结果异常。他们的营养不良程度以及肺部和肝脏受累的严重程度与葡萄糖耐量正常的患者并无差异。OGTT期间的平均胰岛素峰值浓度以及胰岛素积分浓度与葡萄糖耐量正常（GT）和耐量受损（GI）的患者相当。GI组达到胰岛素峰值水平的平均时间显著延迟。（117分钟对86分钟，P小于0.01）。初次检测时，22例患者的HbA1C水平升高。GI组的平均HbA1C水平高于GT组（8.2%对7.5%，P小于0.01）。OGT检测时的HbA1C水平与OGTT期间的血糖反应呈正相关。1年后重复测定的HbA1C值与两组的初始平均HbA1C值无差异。两名初始HbA1C水平分别为7.5%和11% 的GI患者在检测后数月发展为糖尿病。对囊性纤维化患者进行连续HbA1C测定的必要性受到质疑。
