Koloušková Stanislava, Zemková Daniela, Bartošová Jana, Skalická Veronika, Šumník Zdenĕk, Vávrová Vĕra, Lebl Jan
Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and University Hospital Prague-Motol, V Uvalu 84, CZ-150 06 Praha 5, Czech Republic.
J Pediatr Endocrinol Metab. 2011;24(7-8):449-54. doi: 10.1515/jpem.2011.050.
Cystic fibrosis related diabetes (CFRD) is an insulinopenic condition. We aimed to detect insulinopenia early and to evaluate the impact of low dose insulin on nutritional status and forced expiratory volume in first second (FEV1). Out of 142 cystic fibrosis patients (CFpts) older than 10 years, 28 with abnormal oral glucose tolerance test in spite of normal fasting glycemia were found to have decreased first phase insulin release and started low dose insulin therapy (median age 15.4 years). Sex and age matched CFpts with normal glucose tolerance (NGT) were observed for comparison. Whereas nutritional status improved following 3 years of insulin administration, FEV1 stabilized in insulin-treated insulinopenic subjects (73.8 +/- 4.3% vs. 73.5 +/- 4.4%), but decreased in the parallel group with NGT who remained without insulin treatment (71.1 +/- 3.8% vs. 61.0 +/- 4.0%; p = 0.001). We conclude that low dose insulin improves nutritional status and stabilizes pulmonary functions. Regular estimation of stimulated insulin secretion in CFpts may allow optimizing treatment.
囊性纤维化相关糖尿病（CFRD）是一种胰岛素分泌不足的病症。我们旨在早期检测胰岛素缺乏，并评估低剂量胰岛素对营养状况和第一秒用力呼气量（FEV1）的影响。在142名年龄超过10岁的囊性纤维化患者（CF患者）中，发现28名尽管空腹血糖正常但口服葡萄糖耐量试验异常的患者存在第一阶段胰岛素释放减少的情况，并开始接受低剂量胰岛素治疗（中位年龄15.4岁）。观察性别和年龄匹配的糖耐量正常（NGT）的CF患者作为对照。胰岛素治疗3年后，营养状况得到改善，胰岛素治疗的胰岛素缺乏患者的FEV1保持稳定（73.8±4.3%对73.5±4.4%），但未接受胰岛素治疗的平行NGT组患者的FEV1下降（71.1±3.8%对61.0±4.0%；p = 0.001）。我们得出结论，低剂量胰岛素可改善营养状况并稳定肺功能。定期评估CF患者的刺激胰岛素分泌可能有助于优化治疗。
