Stutchfield P R, O'Halloran S, Teale J D, Isherwood D, Smith C S, Heaf D
Department of Child Health, Royal Liverpool Children's Hospital, Alder Hey.
Arch Dis Child. 1987 Aug;62(8):805-10. doi: 10.1136/adc.62.8.805.
Sixty four patients, age range 1-20 years, with cystic fibrosis had their tolerance to glucose assessed according to their glycosylated haemoglobin (HbA1) concentrations. Raised concentrations were found in 24 (37.5%). Oral glucose tolerance tests were performed on 21 patients with raised HbA1 and 13 patients with normal HbA1 concentrations. C peptide responses were also measured to assess islet cell function. Patients with normal HbA1 had normal glucose tolerance and C peptide response. Seven of 21 patients with raised HbA1 concentrations were glucose intolerant. The remaining 14 patients with raised HbA1 concentrations had normal glucose tolerance but a reduced C peptide response, suggesting impaired islet cell function. There were no appreciable differences in the incidence of chest infections, respiratory function, and chest x-ray scores among patients with normal HbA1 concentrations, raised HbA1 concentrations, and normal oral glucose tolerant tests, and patients who were glucose intolerant. No correlation was found between HbA1 concentration and age or Shwachman score. Measuring HbA1 concentrations periodically is useful in detecting and monitoring glucose intolerance in patients with cystic fibrosis.
64例年龄在1至20岁之间的囊性纤维化患者，根据糖化血红蛋白（HbA1）浓度评估其对葡萄糖的耐受性。发现24例（37.5%）患者的HbA1浓度升高。对21例HbA1浓度升高的患者和13例HbA1浓度正常的患者进行了口服葡萄糖耐量试验。还测量了C肽反应以评估胰岛细胞功能。HbA1浓度正常的患者葡萄糖耐量和C肽反应正常。21例HbA1浓度升高的患者中有7例葡萄糖不耐受。其余14例HbA1浓度升高的患者葡萄糖耐量正常但C肽反应降低，提示胰岛细胞功能受损。HbA1浓度正常、HbA1浓度升高且口服葡萄糖耐量试验正常的患者以及葡萄糖不耐受的患者在胸部感染发生率、呼吸功能和胸部X线评分方面没有明显差异。未发现HbA1浓度与年龄或施瓦克曼评分之间存在相关性。定期测量HbA1浓度有助于检测和监测囊性纤维化患者的葡萄糖不耐受情况。
