DIABETES-MELLITUS ASSOCIATED WITH CYSTIC-FIBROSIS
DIABETES-MELLITUS ASSOCIATED WITH CYSTIC-FIBROSIS
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DOI：
10.1016/s0022-3476(88)80315-9
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发表时间：
1988-03-01
影响因子：
5.1
通讯作者：
KLEIN, DJ
中科院分区：
文献类型：
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作者：
FINKELSTEIN, SM;WIELINSKI, CL;KLEIN, DJ
对448例囊性纤维化(CF)患者进行了显性糖尿病和碳水化合物不耐受的研究。7.6%的患者(男性13例，女性21例)发展为胰岛素依赖型糖尿病(IDDM)。IDDM-CF组的存活率显著降低(P<；0.01)，只有不到25%的人存活到30岁，而非糖尿病患者中接近60%的人达到了这个年龄。根据NIH评分，在显性IDDM发病前2年，CF临床状态明显恶化(2年前P<；0.05，IDDM诊断时P<；0.01)。总糖化血红蛋白(Hba1)显著高于(P<；0.001)总的CF人群(7.3%+-)。1.2%)高于一般非CF人群(6.5%+-)。0.7%)，与正常血糖的CF对照组相比，IDDM-CF组(P<；0.05)。女性患者在12岁以后的平均HbA1高于男性患者(P<；0.02)。HbA1不能预测IDDM的发展，但在普通CF人群中，HbA1与NIH临床评分(r=-0.41，P<；0.02)和标准肺功能试验(用力肺活量，r=-0.25，P<；0.01)均呈弱负相关。因此，CF的碳水化合物耐受性受损与进行性临床恶化有关。
The prevalence of overt diabetes mellitus and carbohydrate intolerance was studied in 448 patients with cystic fibrosis (CF). Insulin-dependent diabetes (IDDM) developed in 7.6% of patients (13 male and 21 female). Survival was significantly lower (P < 0.01) in the IDDM-CF group, with fewer than 25% surviving to age 30 years, whereas nearly 60% of the nondiabetic CF population reached this age. A significant deterioration in CF clinical status, based on NIH score, became apparent 2 years before onset of overt IDDM (P < 0.05 at 2 years prior, P < 0.01 at IDDM diagnosis). Total glycosylated hemoglobin (HBA1) was significantly (P < 0.001) higher for the total CF population (7.3% .+-. 1.2%) than for the general non-CF population (6.5% .+-. 0.7%), and in the IDDM-CF group (P < 0.05) compared with normoglycemic CF control patients. Female patients had a higher mean HbA1 after 12 years of age than their male counterparts did (P < 0.02). HBA1 did not predict the development of IDDM, but there was a weak inverse relationship between HbA1 and both NIH clinical score (r=-0.41, P < 0.02) and standard pulmonary function tests (forced vital capacity, r=-0.25, P < 0.01) in the general CF population. Therefore, impaired carbohydrate tolerance in CF is associated with progressive clinical deterioration.