Coriati Adèle, Ziai Sophie, Lavoie Annick, Berthiaume Yves, Rabasa-Lhoret Rémi
Institut de recherches cliniques de Montréal, 110 avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada.
Department of Nutrition, Université de Montréal, Montréal, QC, H3T 1A8, Canada.
Acta Diabetol. 2016 Jun;53(3):359-66. doi: 10.1007/s00592-015-0791-3. Epub 2015 Jul 29.
Cystic fibrosis (CF) is associated with the emergence of CF-related diabetes (CFRD). CFRD is associated with increased risk of accelerated weight and/or lung function loss (clinical degradation). Data in the CF pediatric population reported an association between higher 60-min oral glucose tolerance test (OGTT) plasma glucose values and reduced lung function. Our objective was to evaluate the relationship between the 60-min OGTT insulin and glucose values and markers of clinical degradation in adult patients with CF.
This study was based on an ongoing observational cohort of CF adult patients (≥18 years). All patients underwent a 2-h OGTT with 30-min interval sample measurements. Plasma insulin and glucose levels were measured. Adult patients (N = 240) were categorized based on the 60-min OGTT median values of glucose (G60, 11.0 mmol/L) and/or insulin (I60, 43.4 μU/mL).
A negative association was observed between the 60-min OGTT glucose value and pulmonary function (FEV1; P = 0.001), whereas 60-min OGTT insulin values were positively associated with BMI (P = 0.004). Patients with high G60 values displayed lower FEV1 than patients with low G60 values (P = 0.025). Patients with higher I60 values demonstrated higher values of both FEV1 (P = 0.022) and BMI (P = 0.003) than patients with low I60 values. More importantly, when adjusting for BMI, the difference in FEV1 between both groups no longer existed (P = 0.166).
Both insulin and glucose values at 60-min OGTT are associated with indicators of clinical degradation in adult patients with CF. Future prospective analyses are essential in establishing the clinical utility of these indicators.
囊性纤维化（CF）与CF相关糖尿病（CFRD）的出现有关。CFRD与体重加速增加和/或肺功能丧失（临床恶化）风险增加相关。CF儿科人群的数据报告显示，60分钟口服葡萄糖耐量试验（OGTT）血浆葡萄糖值较高与肺功能降低之间存在关联。我们的目的是评估成年CF患者60分钟OGTT胰岛素和葡萄糖值与临床恶化标志物之间的关系。
本研究基于一项正在进行的CF成年患者（≥18岁）观察性队列研究。所有患者均接受了2小时OGTT，并每隔30分钟测量一次样本。测量血浆胰岛素和葡萄糖水平。成年患者（N = 240）根据60分钟OGTT葡萄糖（G60，11.0 mmol/L）和/或胰岛素（I60，43.4 μU/mL）的中位数进行分类。
观察到60分钟OGTT葡萄糖值与肺功能（FEV1；P = 0.001）之间呈负相关，而60分钟OGTT胰岛素值与BMI呈正相关（P = 0.004）。G60值高的患者FEV1低于G60值低的患者（P = 0.025）。I60值高的患者FEV1（P = 0.022）和BMI（P = 0.003）值均高于I60值低的患者。更重要的是，在调整BMI后，两组之间FEV1的差异不再存在（P = 0.166）。
成年CF患者60分钟OGTT时的胰岛素和葡萄糖值均与临床恶化指标相关。未来的前瞻性分析对于确定这些指标的临床实用性至关重要。
