Glucose intolerance in children with cystic fibrosis

被引:44
作者
Solomon, MP
Wilson, DC
Corey, M
Kalnins, D
Zielenski, J
Tsui, LC
Pencharz, P
Durie, P
Sweezey, NB
机构
[1] Hosp Sick Children, Div Resp Med, Toronto, ON M5G 1X8, Canada
[2] Hosp Sick Children, Div GI Nutr, Toronto, ON M5G 1X8, Canada
[3] Hosp Sick Children, Dept Genet & Populat Hlth Sci, Toronto, ON M5G 1X8, Canada
[4] Univ Toronto, Dept Paediat, Toronto, ON M5S 1A1, Canada
[5] Univ Toronto, Dept Genet, Toronto, ON, Canada
[6] Univ Toronto, Dept Physiol, Toronto, ON, Canada
[7] Univ Toronto, Dept Publ Hlth Sci, Toronto, ON, Canada
关键词
D O I
10.1067/mpd.2003.5
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To evaluate the relations among glucose intolerance, genotype, and exocrine pancreatic status in patients with cystic fibrosis (CF). Study design Data on 335 patients <18 years of age were from the Toronto CF database. A modified oral glucose tolerance test was given to 94 patients 10 to 18 years of age without recognized CF-related diabetes. CF transmembrane conductance regulator mutations and exocrine pancreatic status were determined for all patients. Results CF-related diabetes was clinically recognized in 9 of 335 (2.7%) patients <18 years of age, all of whom were pancreatic insufficient, and 8 of 9 had severe (classes I through III) mutations on both alleles. The ninth patient had unidentified mutations. Although all patients given the oral glucose tolerance test were asymptomatic and had normal fasting blood glucose, 16 of, 94 (17%) had impaired glucose tolerance and 4 of 94 (4.3%) had CF-related diabetes without fasting hyperglycemia. Abnormal glucose tolerance was associated exclusively with severe mutations and exocrine pancreatic insufficiency. Glycosylated hemoglobin (HbA(1)C) levels did not correlate with glucose tolerance results. Conclusions Screening of pancreatic-insufficient, adolescent patients with Cl? identified more with abnormal oral glucose tolerance than was suspected clinically and is recommended as a routine practice. HbA(1)C was not useful in screening for CF-related glucose intolerance.
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收藏
页码:128 / 132
页数:5
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