Factors affecting diabetes mellitus onset in cystic fibrosis: Evidence from a 10-year follow-up study
Factors affecting diabetes mellitus onset in cystic fibrosis: Evidence from a 10-year follow-up study
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DOI：
10.1080/08035259950169747
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发表时间：
1999-04-01
期刊：
影响因子：
3.8
通讯作者：
Arrigo, T
中科院分区：
文献类型：
--
作者：
Cucinotta, D;De Luca, F;Arrigo, T
本研究报告了28例原发性血糖正常的囊性纤维化（CF）患者的基因型特征和10年的临床状态、葡萄糖耐量和胰岛素分泌的前瞻性评价结果。这项研究的目的是评估是否有任何遗传、临床或代谢参数可以提前识别出那些随着时间的推移有患糖尿病风险的患者。在随访期间，42.8%的患者成为糖尿病患者。最终发展为糖尿病的患者与未发展为糖尿病的患者在入组时的性别、年龄和临床参数均无显著差异。两组口服葡萄糖耐量试验（OGTT）期间的胰岛素分泌均随时间推移而恶化，而葡萄糖耐量的进行性恶化仅在发生糖尿病的患者中明显，基线葡萄糖面积增加是糖尿病发作的唯一预测参数。基因型分析显示糖尿病患者和非糖尿病患者之间存在显著差异：第一组中Delta F508纯合子更常见，第二组中N1303 K突变更常见。最后，在CF中：（i）OGTT期间葡萄糖面积增加和葡萄糖耐量随时间的恶化可以预测向糖尿病的演变;和（ii）Delta F508纯合性可能使糖尿病的风险增加，而N1303 K突变似乎起保护作用。
This study reports the results of genotype characterization and of a 10-y prospective evaluation of clinical status, glucose tolerance and insulin secretion in 28 originally normoglycaemic patients with cystic fibrosis (CF). The aim of the study was to assess whether any genetic, clinical or metabolic parameters could identify in advance those patients at risk of developing diabetes mellitus over time. During the follow-up 42.8% of patients became diabetic. Neither gender, age nor clinical parameters were significantly different at entry in the patients who eventually developed diabetes compared with those who did not. Insulin secretion during oral glucose tolerance tests (OGTT) deteriorated over time in both groups, whereas a progressive deterioration of glucose tolerance was only evident in the patients who developed diabetes and increased baseline glucose areas were the only predictive parameter of diabetes onset. Genotype analysis revealed significant differences between patients with and without diabetes: Delta F508 homozygosis was more frequent in the first group and N1303K mutation in the second group. In conclusion, in CF: (i) increased glucose areas during OGTT and deterioration of glucose tolerance over time can predict the evolution towards diabetes; and (ii) Delta F508 homozygosis may predispose to the risk of diabetes, whilst N1303K mutation seems to play a protective role.