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囊性纤维化患者与超重及肥胖患者的口服葡萄糖耐量试验:理解结果的不同方法

Oral Glucose Tolerance Test in Patients with Cystic Fibrosis Compared to the Overweight and Obese: A Different Approach in Understanding the Results.

作者信息

Mogoi Mirela, Pop Liviu Laurentiu, Dediu Mihaela, Ciuca Ioana Mihaiela

机构信息

Pediatric Department, University of Medicine and Pharmacy "Victor Babes", 300041 Timisoara, Romania.

Pediatric Pulmonology Unit, National Cystic Fibrosis Centre, Clinical County Hospital Timisoara, 300226 Timisoara, Romania.

出版信息

Children (Basel). 2022 Apr 8;9(4):533. doi: 10.3390/children9040533.

Abstract

(1) Background: In cystic fibrosis (CF), the oral glucose tolerance test (OGTT) is recommended from 10 years old annually to screen and diagnose cystic fibrosis-related diabetes (CFRD). Alternative OGTT characteristics (glucose curve shape, time to glucose peak, one-hour glucose value, and three-hour glucose value with the new shape curve) were studied in other populations considered at high risk for diabetes; (2) Methods: The study analyses classical and alternative OGGT characteristics from 44 children (22 CF, 22 obese without CF), mean age: 12.9 ± 2.2 years evaluated in a single-center from Romania. (3) Results: In 59.1% of children with CF, the predominant OGTT pattern was: abnormal glucose metabolism or CFRD, with a monophasic curve shape, a late peak glucose level, and 1 h glucose ≥ 155 mg/dL, showing a very different pattern compared with sex and age-matched obese children. Statistical estimation agreement between the late glucose peak (K = 0.60; = 0.005), the 1 h glucose ≥ 155 mg/dL during OGTT (K = 0.69, = 0.001), and the classical method of interpretation was found. (4) Conclusions: Late peak glucose and 1 h glucose level ≥ 155 mg/dL during OGTT can be used for diagnosing the early glucose metabolism alteration in children with CF.

摘要

(1)背景:在囊性纤维化(CF)中,建议从10岁起每年进行口服葡萄糖耐量试验(OGTT),以筛查和诊断囊性纤维化相关糖尿病(CFRD)。在其他被认为有糖尿病高风险的人群中,研究了OGTT的替代特征(葡萄糖曲线形状、血糖峰值时间、1小时血糖值以及新形状曲线下的3小时血糖值);(2)方法:该研究分析了来自罗马尼亚单中心的44名儿童(22名CF患儿,22名非CF肥胖儿童)的经典和替代OGGT特征,平均年龄为12.9±2.2岁。(3)结果:在59.1%的CF患儿中,主要的OGTT模式为:葡萄糖代谢异常或CFRD,曲线形状为单相,血糖峰值出现较晚,1小时血糖≥155mg/dL,与性别和年龄匹配的肥胖儿童相比,呈现出非常不同的模式。在血糖峰值出现较晚(K = 0.60;P = 0.005)、OGTT期间1小时血糖≥155mg/dL(K = 0.69,P = 0.001)与经典解释方法之间发现了统计学估计一致性。(4)结论:OGTT期间血糖峰值出现较晚以及1小时血糖水平≥155mg/dL可用于诊断CF患儿早期葡萄糖代谢改变。

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