Abnormal glucose tolerance and lung function in children with cystic fibrosis. Comparing oral glucose tolerance test and continuous glucose monitoring
Abnormal glucose tolerance and lung function in children with cystic fibrosis. Comparing oral glucose tolerance test and continuous glucose monitoring
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DOI：
10.1016/j.jcf.2021.01.002
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发表时间：
2021-09-21
影响因子：
5.2
通讯作者：
Hansen, C. R.
中科院分区：
文献类型：
--
作者：
Elidottir, H.;Diemer, S.;Hansen, C. R.
背景：囊性纤维化（CF）相关糖尿病（CFRD）是CF的常见并发症。CFRD甚至在发病前就与肺功能下降有关。建议使用口服葡萄糖耐量试验（OGTT）定期筛查CFRD。此外，动态血糖监测（CGM）已成为一种可能的监测方法，但尚未建立其使用及其与OGTT一致性的证据。方法：在CF中心隆德前瞻性招募儿童，接受间歇性扫描CGM（isCGM）和OGTT。肺功能通过肺功能测定和多次呼吸洗脱进行评估。从瑞典国家CF registry.Results收集人口统计学和临床数据：32例患者参加了这项研究，产生28对isCGMs和OGTT。OGTT结果显示2例符合CFRD标准，7例为糖耐量减低（IGT），11例为不确定性糖耐量减低（INET）。isCGM> 8 mmol/L的百分比和>11 mmol/L的峰值数与OGTT中间血糖时间点相关，而与2 h血糖值无关。糖耐量异常（AGT）患者肺功能较糖耐量正常者明显降低，肺清除指数（LCI）和FEV1%预测值均低于糖耐量正常者。LCI显示CF中糖耐量异常的儿童和青少年的肺功能以及FEV1%预测值更差。(C)2021作者由Elsevier B. V.代表欧洲囊性纤维化协会出版。
Background: Cystic fibrosis (CF) related diabetes (CFRD) is a common complication of CF. CFRD is associated with declining lung function even before its onset. Regular screening for CFRD using oral glucose tolerance test (OGTT) is recommended. Additionally, continuous glucose monitoring (CGM) has surfaced as a possible surveillance method, but evidence for its use and concordance with OGTT has not been established.Methods: Children were prospectively recruited at CF center Lund to undergo both intermittent scan CGM (isCGM) and OGTT. Lung function was evaluated by spirometry and multiple breath washout. Demographic and clinical data were collected from the Swedish national CF registry.Results: 32 patients participated in the study, yielding 28 pairs of isCGMs and OGTTs. The OGTTs showed that two patients met the criteria of CFRD, seven had impaired glucose tolerance (IGT) and indeterminate glycemia (INDET) was found in eleven cases. The isCGM percent of measurements >8mmol/L and the number of peaks per day >11 mmol/L have correlations with intermediate OGTT glucose time points, but not the 2hour glucose value. Patients with abnormal glucose tolerance (AGT) had lower lung function than those with normal glucose tolerance demonstrated by both FEV1% predicted and lung clearance index (LCI).Conclusion: Correlations can be found between isCGM and OGTT in regards to the latter's intermediate time points. LCI demonstrates as well as FEV1% of predicted, worse lung function in children and adolescents with abnormal glucose tolerance in CF. (C) 2021 The Authors. Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society.