Kirigin Biloš Lora Stanka, Baretić Maja, Vukić Dugac Andrea, Schoenwald Krešimir, Bambir Ivan, Tješić Drinković Duška, Krnić Nevena, Altabas Velimir
Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Centre "Sestre Milosrdnice", 10000 Zagreb, Croatia.
Department of Endocrinology and Diabetology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia.
Life (Basel). 2025 May 20;15(5):815. doi: 10.3390/life15050815.
This study investigated the prevalence of cystic fibrosis-related diabetes (CFRD) in the Croatian cystic fibrosis (CF) population, the age at diagnosis, insulin requirements, and the relationship between age at diagnosis and other clinical parameters. Medical records from 152 patients with genetically and laboratory-confirmed CF were reviewed through to 2025. The American Diabetes Association criteria were used to diagnose CFRD. Anthropometric and clinical data were collected from the latest medical records. A total of 17 out of 152 patients had CFRD, with a prevalence of 4.8% in the paediatric population (4/84) and 19.1% in adults (13/68). The median age of CFRD diagnosis was 14 years (range 9-22 years, SD = 3.95). Thirteen patients used insulin: one used bolus only, seven used basal-bolus multiple daily injections, and five used insulin pumps. The average total daily insulin (TDI) per kilogram (kg) body weight was 0.447 U/kg (SD = 0.429). The age at CFRD diagnosis was positively correlated with the body mass index (BMI) ( = 0.029). Patients requiring insulin by age 15 had higher TDI and were more likely to have CF liver disease ( = 0.027, = 0.037, respectively). The prevalence of CFRD and age at diagnosis aligned with previous studies. Patients diagnosed at a younger age and requiring insulin earlier had lower BMIs, likely due to a faster decline in beta cell function and earlier onset of insulinopenia.
本研究调查了克罗地亚囊性纤维化（CF）人群中囊性纤维化相关糖尿病（CFRD）的患病率、诊断年龄、胰岛素需求量，以及诊断年龄与其他临床参数之间的关系。对152例经基因和实验室确诊为CF的患者的病历进行了回顾，直至2025年。采用美国糖尿病协会标准诊断CFRD。从最新病历中收集人体测量和临床数据。152例患者中共有17例患有CFRD，儿童人群患病率为4.8%（4/84），成人患病率为19.1%（13/68）。CFRD诊断的中位年龄为14岁（范围9 - 22岁，标准差 = 3.95）。13例患者使用胰岛素：1例仅使用推注胰岛素，7例使用基础 - 推注每日多次注射，5例使用胰岛素泵。每千克体重的平均每日胰岛素总量（TDI）为0.447 U/kg（标准差 = 0.429）。CFRD诊断年龄与体重指数（BMI）呈正相关（ = 0.029）。15岁前需要胰岛素治疗的患者TDI较高，且更有可能患有CF肝病（分别为 = 0.027， = 0.037）。CFRD的患病率和诊断年龄与先前研究一致。诊断年龄较小且较早需要胰岛素治疗的患者BMI较低，这可能是由于β细胞功能下降更快和胰岛素缺乏症发病更早。
