The 1-h oral glucose tolerance test glucose and insulin values are associated with markers of clinical deterioration in cystic fibrosis
The 1-h oral glucose tolerance test glucose and insulin values are associated with markers of clinical deterioration in cystic fibrosis
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DOI：
10.1007/s00592-015-0791-3
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发表时间：
2016-06-01
影响因子：
3.8
通讯作者：
Rabasa-Lhoret, Remi
中科院分区：
文献类型：
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作者：
Coriati, Adele;Ziai, Sophie;Rabasa-Lhoret, Remi
囊性纤维化（CF）与CF相关性糖尿病（CFRD）的出现有关。CFRD与体重加速和/或肺功能丧失（临床退化）的风险增加有关。CF儿童人群的数据报告了较高的60分钟口服葡萄糖耐量试验（OGTT）血浆葡萄糖值与肺功能降低之间的关联。我们的目的是评估成人CF患者60分钟OGTT胰岛素和葡萄糖值与临床退化标志物之间的关系。方法本研究基于CF成人患者（>= 18岁）的持续观察队列。所有患者都进行了2小时OGTT，间隔30分钟进行样本测量。测量血浆胰岛素和葡萄糖水平。根据60分钟OGTT血糖（G60, 11.0 mmol/L）和/或胰岛素（I60, 43.4 mu U/mL）中位数对成年患者（N = 240）进行分类。结果60分钟OGTT血糖值与肺功能呈负相关（FEV1, P = 0.001），而60分钟OGTT胰岛素值与BMI呈正相关（P = 0.004）。G60值高的患者FEV1低于G60值低的患者（P = 0.025）。I60值高的患者FEV1 （P = 0.022）和BMI （P = 0.003）均高于I60值低的患者。更重要的是，在调整BMI后，两组FEV1的差异不再存在（P = 0.166）。结论：60分钟OGTT时的胰岛素和葡萄糖值与成年CF患者的临床退化指标相关，未来的前瞻性分析对于确定这些指标的临床应用至关重要。
Aims Cystic fibrosis (CF) is associated with the emergence of CF-related diabetes (CFRD). CFRD is associated with increased risk of accelerated weight and/or lung function loss (clinical degradation). Data in the CF pediatric population reported an association between higher 60-min oral glucose tolerance test (OGTT) plasma glucose values and reduced lung function. Our objective was to evaluate the relationship between the 60-min OGTT insulin and glucose values and markers of clinical degradation in adult patients with CF.Methods This study was based on an ongoing observational cohort of CF adult patients (>= 18 years). All patients underwent a 2-h OGTT with 30-min interval sample measurements. Plasma insulin and glucose levels were measured. Adult patients (N = 240) were categorized based on the 60-min OGTT median values of glucose (G60, 11.0 mmol/L) and/or insulin (I60, 43.4 mu U/mL).Results A negative association was observed between the 60-min OGTT glucose value and pulmonary function (FEV1; P = 0.001), whereas 60-min OGTT insulin values were positively associated with BMI (P = 0.004). Patients with high G60 values displayed lower FEV1 than patients with low G60 values (P = 0.025). Patients with higher I60 values demonstrated higher values of both FEV1 (P = 0.022) and BMI (P = 0.003) than patients with low I60 values. More importantly, when adjusting for BMI, the difference in FEV1 between both groups no longer existed (P = 0.166).Conclusions Both insulin and glucose values at 60-min OGTT are associated with indicators of clinical degradation in adult patients with CF. Future prospective analyses are essential in establishing the clinical utility of these indicators.