Skopnik H, Kentrup H, Kusenbach G, Pfäffle R, Kock R
Kinderklinik, Rheinisch-Westfälische Technische Hochschule Aachen.
Monatsschr Kinderheilkd. 1993 Jan;141(1):42-7.
Glucose tolerance is often impaired in Cystic Fibrosis. The impact of this condition on enteral nutritional support in case of malnourishment remains to be studied.
In this study the glucose-, C-peptide- and insulin-responses to an OGTT and a standard enteral formula load were investigated in 19 non-diabetic CF-patients. Each test was performed with a carbohydrate load of 1.75 g/kg bodyweight.
11 patients had a normal OGTT (Group I) and 8 had an impaired glucose tolerance (Group II). After the formula load the glucose concentrations were significantly lower than after the OGTT at 30, 60, and 90 min in both groups and at 120 min in group II only. In group II the glucose values exceeded 6.7 mmol/l at 120 min after both OGTT and formula load and were significantly higher than in group I. The food glycaemic index, a parameter for comparison of glucose response to different diets was calculated. It ranged from 30 to 80% in both groups. An increased C-peptide- and insulin-secretion was found in patients with impaired glucose tolerance.
The condition of impaired glucose tolerance must be considered for enteral hyperalimentation of Cystic Fibrosis-patients. The selection of formulas for nutritional support should be based on the calculation of the Food Glycemic Index because of its high interindividual variability.
囊性纤维化患者常出现糖耐量受损。这种情况对营养不良时肠内营养支持的影响仍有待研究。
本研究对19名非糖尿病囊性纤维化患者进行了口服葡萄糖耐量试验（OGTT）和标准肠内配方负荷后葡萄糖、C肽和胰岛素反应的研究。每项试验的碳水化合物负荷均为1.75 g/kg体重。
11名患者OGTT正常（第一组），8名患者糖耐量受损（第二组）。给予配方负荷后，两组在30、60和90分钟时的葡萄糖浓度均显著低于OGTT后，第二组仅在120分钟时如此。在第二组中，OGTT和配方负荷后120分钟时的葡萄糖值均超过6.7 mmol/l，且显著高于第一组。计算了食物血糖指数，这是一个用于比较不同饮食葡萄糖反应的参数。两组的食物血糖指数范围均为30%至80%。糖耐量受损患者的C肽和胰岛素分泌增加。
对于囊性纤维化患者的肠内高营养，必须考虑糖耐量受损的情况。由于个体差异较大，营养支持配方的选择应基于食物血糖指数的计算。
