Cystic fibrosis-related diabetes: current trends in prevalence, incidence, and mortality.
Cystic fibrosis-related diabetes: current trends in prevalence, incidence, and mortality.
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DOI：
10.2337/dc09-0586
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发表时间：
2009-09
期刊：
影响因子：
16.2
通讯作者：
Thomas W
中科院分区：
文献类型：
--
作者：
Moran A;Dunitz J;Nathan B;Saeed A;Holme B;Thomas W
囊性纤维化（CF）相关的糖尿病（CFRD）的诊断和管理有很大的变化，因为糖尿病首次被证明与CF患者的预后不良。目前CFRD患病率、发病率和死亡率的趋势是从综合临床数据库中确定的。我们回顾了明尼苏达大学872名CF患者在1992-1997年、1998-2002年和2003-2008年三个连续时间段内的数据。目前，2%的儿童、19%的青少年和40-50%的成年人患有CFRD。30-39岁女性受试者的发病率和患病率较高;除此之外，没有性别差异。在年轻个体中，无空腹高血糖的CFRD占主导地位，但空腹高血糖患病率随年龄增长而上升。随着时间的推移，面板堆石坝死亡率显著下降。从1992-1997年到2003-2008年，女性受试者的死亡率下降了50%以上，从每100患者年6.9例死亡降至3.2例，男性受试者从每100患者年6.5例死亡降至3.8例。死亡率不再有性别差异。糖尿病以前被诊断为近20%患者的围发病期事件，但在2003-2008年期间诊断为糖尿病的61例患者中，只有2例死亡。与非糖尿病患者相比，合并糖尿病的CF患者的肺功能仍然较差，但营养状况并不差。无空腹高血糖和空腹高血糖患者的营养状况和肺部状况相似。以前注意到的死亡率的性别差异已经消失，有糖尿病和无糖尿病的CF患者之间死亡率的差距已经大大缩小。我们认为早期诊断和积极治疗在提高这些患者的生存率方面发挥了重要作用。
Cystic fibrosis (CF)-related diabetes (CFRD) diagnosis and management have considerably changed since diabetes was first shown to be associated with a poor prognosis in subjects with CF. Current trends in CFRD prevalence, incidence, and mortality were determined from a comprehensive clinical database. Data were reviewed from 872 CF patients followed at the University of Minnesota during three consecutive intervals: 1992–1997, 1998–2002, and 2003–2008. CFRD is currently present in 2% of children, 19% of adolescents, and 40–50% of adults. Incidence and prevalence are higher in female subjects aged 30–39 years; otherwise, there are no sex differences. In younger individuals, CFRD without fasting hyperglycemia predominates, but fasting hyperglycemia prevalence rises with age. CFRD mortality has significantly decreased over time. From 1992–1997 to 2003–2008, mortality rate in female subjects dropped by >50% from 6.9 to 3.2 deaths per 100 patient-years and in male subjects from 6.5 to 3.8 deaths per 100 patient-years. There is no longer a sex difference in mortality. Diabetes was previously diagnosed as a perimorbid event in nearly 20% of patients, but of 61 patients diagnosed with diabetes during 2003–2008, only 2 died. Lung function but not nutritional status is still worse in CF patients with diabetes compared with those without diabetes. Nutritional status and pulmonary status are similar between patients without fasting hyperglycemia and those with fasting hyperglycemia. Previously noted sex differences in mortality have disappeared, and the gap in mortality between CF patients with and without diabetes has considerably narrowed. We believe that early diagnosis and aggressive treatment have played a major role in improving survival in these patients.
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影响因子：
5.1
作者：
Bismuth, Elise;Laborde, Kathleen;Robert, Jean-Jacques
通讯作者：
Robert, Jean-Jacques
影响因子：
16.2
作者：
Milla, CE;Billings, J;Moran, A
通讯作者：
Moran, A
影响因子：
3.1
作者：
Koch, C;Rainisio, M;Strandvik, B
通讯作者：
Strandvik, B
影响因子：
3.6
作者：
LANNG, S;THORSTEINSSON, B;KOCH, C
通讯作者：
KOCH, C
影响因子：
5.1
作者：
FINKELSTEIN, SM;WIELINSKI, CL;KLEIN, DJ
通讯作者：
KLEIN, DJ