Full The Relationship between Continuous Glucose Monitoring and OGTT in Youth and Young Adults with Cystic Fibrosis.
Full The Relationship between Continuous Glucose Monitoring and OGTT in Youth and Young Adults with Cystic Fibrosis.
复制标题
完整的囊性纤维化青少年和年轻人的连续血糖监测与 OGTT 之间的关系。
DOI：
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发表时间：
2021
影响因子：
5.8
通讯作者：
K. Nadeau
中科院分区：
文献类型：
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作者：
Christine L. Chan;L. Pyle;T. Vigers;P. Zeitler;K. Nadeau
背景
CF 患者 (PwCF) 的早期血糖异常通常可以通过连续血糖监测 (CGM) 来检测。 PwCF 中这些 CGM 异常与口服葡萄糖耐量试验 (OGTT) 之间的关系尚未得到充分表征。
目标
1) 确定 CGM 与常见的 OGTT 衍生的 β 细胞功能评估（包括 C 肽指数和口腔倾向指数 (oDI)）之间的关系；2) 探讨 CGM 是否可用于筛查 OGTT 定义的糖尿病前期和囊性纤维化相关糖尿病 (CFRD)。
研究设计/方法
PwCF 未使用胰岛素，并且年龄 6-25 岁的健康对照者参加了一项收集 OGTT 和 CGM 的前瞻性研究。一个子集接受了频繁采样的 OGTT (fsOGTT)，其中包括 7 点葡萄糖、胰岛素和 C 肽测量。 Pearson 相关系数用于测试选定 CGM 和 fsOGTT 测量之间的关联。 ROC 分析应用于 CGM 变量，以确定检测糖尿病前期和 CFRD 的最佳灵敏度和特异性截止值。
结果
共有 120 名参与者（对照组 = 35，CF = 85），其中 69 名患有 fsOGTT。 CGM变异系数与C肽指数（C肽30-C肽0/Glucose30-Glucose0）（r=-0.45，p<0.001）和oDIcp肽（C肽指数）（1/cpep0）（r=-0.48，p<0.0001）呈反比。在 PwCF 中，糖尿病前期的 CGM 变量的 ROC-AUC 范围为 0.43-0.57，CFRD 的 ROC-AUC 范围为 0.47-0.6。
结论
CGM 的较大血糖变异性与 β 细胞功能降低相关。然而，CGM 在区分患有或不患有 OGTT 定义的 CFRD 和糖尿病前期的个体方面表现不佳。现在需要进行前瞻性研究来确定不同测试对 PwCF 临床相关非血糖结果的预测效果。
CONTEXT
Early glucose abnormalities in people with CF (PwCF) are commonly detected by continuous glucose monitoring (CGM). Relationships between these CGM abnormalities and oral glucose tolerance testing (OGTT) in PwCF have not been fully characterized.
OBJECTIVE(S)
1) To determine the relationship between CGM and common OGTT-derived estimates of β-cell function, including C-peptide index and oral disposition index (oDI) and 2) to explore whether CGM can be used to screen for OGTT-defined prediabetes and cystic fibrosis related diabetes (CFRD).
STUDY DESIGN/METHODS
PwCF not on insulin and healthy controls ages 6-25 yrs were enrolled in a prospective study collecting OGTT and CGM. A subset underwent frequently-sampled OGTTs (fsOGTT) with 7-point glucose, insulin, and C-peptide measurements. Pearson's correlation coefficient was used to test the association between select CGM and fsOGTT measures. ROC analysis was applied to CGM variables to determine the cutoff optimizing sensitivity and specificity for detecting prediabetes and CFRD.
RESULTS
A total of 120 participants (controls=35, CF=85), including 69 with fsOGTTs, were included. CGM coefficient of variation correlated inversely with C-peptide index (Cpeptide30-Cpeptide0/Glucose30-Glucose0) (r=-0.45, p<0.001) and oDIcpeptide (C-peptide index)(1/cpep0) (r=-0.48, p<0.0001). In PwCF, CGM variables had ROC-AUCs ranging from 0.43-0.57 for prediabetes and 0.47-0.6 for CFRD.
CONCLUSIONS
Greater glycemic variability on CGM correlated with reduced β-cell function. However, CGM performed poorly at discriminating individuals with and without OGTT-defined CFRD and prediabetes. Prospective studies are now needed to determine how well the different tests predict clinically-relevant non-glycemic outcomes in PwCF.
影响因子：
16.2
作者：
Stumvoll, M;Mitrakou, A;Gerich, J
通讯作者：
Gerich, J
影响因子：
8
作者：
Hart, Nathaniel J.;Aramandla, Radhika;Powers, Alvin C.
通讯作者：
Powers, Alvin C.
影响因子：
16.2
作者：
Matsuda, M;DeFronzo, RA
通讯作者：
DeFronzo, RA