Banavath Lakshmipathi Naik, Kumar Rakesh, Dayal Devi, Yadav Jaivinder, Sachdeva Naresh, Mathew Joseph L, Vaidya Pankaj C, Singh Meenu
Pediatric Endocrinology and Diabetes Division, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India.
Pediatric Pulmonology Division, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India.
J Pediatr Endocrinol Metab. 2018 Oct 25;31(10):1139-1146. doi: 10.1515/jpem-2018-0222.
Background Cystic fibrosis-related diabetes (CFRD) is a common comorbidity reported in patients with cystic fibrosis (CF). There is a dearth of data on glucose intolerance or CFRD in children with CF from developing countries. So, we planned to study the prevalence of abnormal glucose tolerance (AGT) in children with CF and its relation with the duration and severity of CF. Methods We performed an oral glucose tolerance test (OGTT) on children (2-18 years old) having CF for at least 6 months. Two-hour plasma glucose levels on OGTT were correlated with various disease-related factors. Results Out of the 25 children enrolled, there were 18 boys and seven girls. The mean age and duration of CF were 7.9±4.3 and 3.16±2.5 years, respectively. AGT was observed in 16 (64%) children with CF including three (12%) children with CFRD. Children with a duration of CF of 3 years had significantly higher prevalence (81.8%) of AGT when compared with duration ≤3 years (p-value<0.05). Twelve out of 17 (70.6%) children were colonized with Pseudomonas and 12 out of 15 (80%) children >6 years of age had AGT. There was a positive correlation of 2-h glucose value on OGTT with duration of CF and number of hospitalizations with acute pulmonary exacerbations. Conclusions The majority of children having CF for >3 years and/or age >6 years developed AGT. In our clinical setting, an annual screening with OGTT to detect AGT may be required at an early age and duration of CF.
囊性纤维化相关糖尿病（CFRD）是囊性纤维化（CF）患者中常见的合并症。发展中国家CF儿童中关于葡萄糖耐量异常或CFRD的数据匮乏。因此，我们计划研究CF儿童中异常葡萄糖耐量（AGT）的患病率及其与CF病程和严重程度的关系。
我们对患有CF至少6个月的2至18岁儿童进行了口服葡萄糖耐量试验（OGTT）。OGTT的两小时血浆葡萄糖水平与各种疾病相关因素相关。
在纳入的25名儿童中，有18名男孩和7名女孩。CF的平均年龄和病程分别为7.9±4.3岁和3.16±2.5年。16名（64%）CF儿童观察到AGT，其中3名（12%）为CFRD儿童。CF病程为3年的儿童AGT患病率（81.8%）显著高于病程≤3年的儿童（p值<0.05）。17名儿童中有12名（70.6%）感染了铜绿假单胞菌，15名6岁以上儿童中有12名（80%）有AGT。OGTT的2小时血糖值与CF病程和急性肺部加重住院次数呈正相关。
大多数CF病程>3年和/或年龄>6岁的儿童出现AGT。在我们的临床环境中，可能需要在CF的早期和病程中每年进行OGTT筛查以检测AGT。
