Variation of glucose tolerance in adult patients with cystic fibrosis: What is the potential contribution of insulin sensitivity?

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• 作者：Valé ; rie Boudreau^a ; ^b ; ¹ ; ^{valerie.boudreau@ircm.qc.ca} ; Adè ; le Coriati^a ; ^b ; ¹ ; ^{adele.coriati@ircm.qc.ca} ; Imane Hammana^a ; ^b ; ^{imane.hammana.chum@ssss.gouv.qc.ca} ; Sophie Ziai^a ; ^b ; ^{sophie.1.ziai@gmail.com} ; Katherine Desjardins^a ; ^b ; ^{katherine.desjardins@ircm.qc.ca} ; Yves Berthiaume^a ; ^c ; ^d ; ^{yves.berthiaume@ircm.qc.ca} ; Ré ; mi Rabasa-Lhoret^a ; ^b ; ^c ; ^d ; ^{remi.rabasa-lhoret@ircm.qc.ca}
• 关键词：ANOVA ; analyses of variance ; AUC ; area under the curve ; CF ; cystic fibrosis ; CFRD ; cystic fibrosis-related diabetes ; FEV1 ; forced expiratory volume in 1  ; s ; HbA1c ; glycated hemoglobin ; IGT ; impaired glucose tolerance ; BMI ; body mass index ; MCFC ; Montreal Cystic Fibrosis Cohort ; NGT ; normal glucose tolerance ; OGTT ; oral glucose tolerance test
• 刊名：Journal of Cystic Fibrosis
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：15
• 期：6
• 页码：839-845
• 全文大小：367 K
• 卷排序：15

文摘

Reduced insulin secretion is a key factor to explain high prevalence of glucose intolerance in patients with cystic fibrosis (CF). However, the role of insulin sensitivity remains unclear. The aim of this study is to investigate the association of insulin secretion and sensitivity with the evolution of glucose tolerance.MethodsA total of 152 patients without known diabetes from the Montreal CF cohort underwent two 2-h oral glucose tolerance tests (OGTT) at baseline and again after 21.2 ± 5.5 months. Pulmonary function and anthropometric measurements were also collected at each visit. At both visits, based on their OGTT results, patients were categorized in glucose tolerance groups (normal glucose tolerance, impaired glucose tolerance or CF-related diabetes) and stratified in 3 groups according to the variation of their glucose tolerance: stable, improved or deteriorated.ResultsAt baseline, patients in the deteriorated group had a better sensitivity to insulin than those in the improved group (P = 0.029). At follow-up glucose tolerance remained stable in 55.3%, improved in 14.5% and deteriorated in 30.3% of patients. During follow-up, insulin secretion remained stable in all 3 groups. While insulin sensitivity remained stable in patients without changes in glucose tolerance it worsened in patients who deteriorated glucose tolerance (P < 0.001) and improved in patients who improved their glucose tolerance (P = 0.003).ConclusionIn a context of significantly reduced insulin secretion, variations of insulin sensitivity are associated with variations of glucose tolerance in adult patients with CF.