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连续血糖监测在囊性纤维化患者早期糖代谢异常及临床结局中的作用。

The Role of Continuous Glucose Monitoring in Detecting Early Dysglycemia and Clinical Outcomes in Patients with Cystic Fibrosis.

机构信息

Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Centre "Sestre Milosrdnice", 10000 Zagreb, Croatia.

School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.

出版信息

Medicina (Kaunas). 2024 Mar 14;60(3):477. doi: 10.3390/medicina60030477.

Abstract

Cystic fibrosis-related diabetes (CFRD) is the most common comorbidity in patients with cystic fibrosis (CF). CFRD has been correlated with important clinical outcomes, including poor nutrition, reduced pulmonary function, and earlier mortality. However, clinical decline due to abnormalities of blood glucose (dysglycemia) begins early in CF, before the diagnosis of CFRD by the gold-standard oral glucose tolerance test (OGTT). Continuous glucose monitoring (CGM) has been validated in patients with CF and has been recognized as a valuable tool in detecting early glucose abnormalities in patients with CF. Several CGM parameters have been used to predict CFRD in some but not all studies, and there is no consensus regarding CGM use for diagnostic purposes. Thus, it remains a complementary test to OGTT in CFRD diagnosis. The aim of this review is to provide an update on the pathophysiological mechanisms of CFRD, recent advances in the use of CGM for CFRD screening, and the association between CGM measures and CF-related clinical outcomes.

摘要

囊性纤维化相关性糖尿病(CFRD)是囊性纤维化(CF)患者最常见的合并症。CFRD 与重要的临床结局相关,包括营养状况不佳、肺功能下降和更早的死亡率。然而,由于血糖异常(糖代谢紊乱)引起的临床恶化早在 CF 患者通过金标准口服葡萄糖耐量试验(OGTT)诊断 CFRD 之前就已经开始。连续血糖监测(CGM)已在 CF 患者中得到验证,并已被认为是检测 CF 患者早期血糖异常的有价值工具。一些 CGM 参数已被用于预测某些研究中的 CFRD,但并非所有研究都一致,并且关于 CGM 在诊断目的中的使用也没有共识。因此,它仍然是 CFRD 诊断中 OGTT 的补充测试。本综述的目的是提供 CFRD 的病理生理学机制的最新信息,CGM 在 CFRD 筛查中的最新应用进展,以及 CGM 测量值与 CF 相关临床结局之间的关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b58f/10972086/3105943b07c6/medicina-60-00477-g001.jpg

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