Anne Bonhoure1,2, Kathryn J Potter1, Johann Colomba1,3, Valérie Boudreau1,3, Cindy Bergeron1,3, Katherine Desjardins1, Maïté Carricart4,5, François Tremblay4,5, Annick Lavoie4,5, Rémi Rabasa-Lhoret6,7,8,9. 1. Montreal Clinical Research Institute, Montreal, QC, Canada. 2. Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada. 3. Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada. 4. Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC, Canada. 5. Cystic Fibrosis Clinic, University of Montreal Hospital Center (CHUM), Montreal, QC, Canada. 6. Montreal Clinical Research Institute, Montreal, QC, Canada. remi.rabasa-lhoret@ircm.qc.ca. 7. Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada. remi.rabasa-lhoret@ircm.qc.ca. 8. Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC, Canada. remi.rabasa-lhoret@ircm.qc.ca. 9. Cystic Fibrosis Clinic, University of Montreal Hospital Center (CHUM), Montreal, QC, Canada. remi.rabasa-lhoret@ircm.qc.ca.
Abstract
AIMS/HYPOTHESIS: Cystic fibrosis-related diabetes (CFRD) affects up to 50% of adults with cystic fibrosis (CF) and its presence is associated with adverse effects on nutritional status and pulmonary function. Early diagnosis could minimise CFRD morbidity, yet current methods of an OGTT at 0 and 2 h yield unreliable results. Our aim was to determine which indices from a 2 h OGTT with sampling every 30 min might improve prediction of CFRD. METHODS: Cross-sectional analysis at baseline (n = 293) and observational prospective analysis (n = 185; mean follow-up of 7.5 ± 4.2 years) of the Montreal Cystic Fibrosis Cohort were performed. Blood glucose and insulinaemia OGTT variables were studied in relation to lung function (forced expiratory volume in 1 s [FEV1]), BMI and risk of developing CFRD. RESULTS: At baseline, maximum OGTT glucose (Gmax) was negatively associated with FEV1 (p = 0.003). Other OGTT values, including classical 2 h glucose, were not. A higher Gmax was associated with lower insulin secretory capacity, delayed insulin peak timing and greater pancreatic insufficiency (p < 0.01). Gmax was positively associated with the risk of developing CFRD (p = 0.0029); no individual with a Gmax < 8 mmol/l developed CFRD over the following decade. No OGTT variable correlated to the rate of change in BMI or FEV1. CONCLUSIONS/ INTERPRETATION: In adults with CF, Gmax is strongly associated with the risk of developing CFRD; Gmax < 8 mmol/l could identify those at very low risk of future CFRD. Gmax is higher in individuals with pancreatic insufficiency and is associated with poorer insulin secretory capacity and pulmonary function.
AIMS/HYPOTHESIS: Cystic fibrosis-related diabetes (CFRD) affects up to 50% of adults with cystic fibrosis (CF) and its presence is associated with adverse effects on nutritional status and pulmonary function. Early diagnosis could minimise CFRD morbidity, yet current methods of an OGTT at 0 and 2 h yield unreliable results. Our aim was to determine which indices from a 2 h OGTT with sampling every 30 min might improve prediction of CFRD. METHODS: Cross-sectional analysis at baseline (n = 293) and observational prospective analysis (n = 185; mean follow-up of 7.5 ± 4.2 years) of the Montreal Cystic Fibrosis Cohort were performed. Blood glucose and insulinaemia OGTT variables were studied in relation to lung function (forced expiratory volume in 1 s [FEV1]), BMI and risk of developing CFRD. RESULTS: At baseline, maximum OGTT glucose (Gmax) was negatively associated with FEV1 (p = 0.003). Other OGTT values, including classical 2 h glucose, were not. A higher Gmax was associated with lower insulin secretory capacity, delayed insulin peak timing and greater pancreatic insufficiency (p < 0.01). Gmax was positively associated with the risk of developing CFRD (p = 0.0029); no individual with a Gmax < 8 mmol/l developed CFRD over the following decade. No OGTT variable correlated to the rate of change in BMI or FEV1. CONCLUSIONS/ INTERPRETATION: In adults with CF, Gmax is strongly associated with the risk of developing CFRD; Gmax < 8 mmol/l could identify those at very low risk of future CFRD. Gmax is higher in individuals with pancreatic insufficiency and is associated with poorer insulin secretory capacity and pulmonary function.
Authors: M Costa; S Potvin; Y Berthiaume; L Gauthier; A Jeanneret; A Lavoie; R Levesque; Jl Chiasson; R Rabasa-Lhoret Journal: Diabetes Metab Date: 2005-06 Impact factor: 6.041
Authors: Amanda L Brennan; Khin M Gyi; David M Wood; Julie Johnson; Rick Holliman; Deborah L Baines; Barbara J Philips; Duncan M Geddes; Margaret E Hodson; Emma H Baker Journal: J Cyst Fibros Date: 2006-07-17 Impact factor: 5.482
Authors: Mahroukh Rafii; Karen Chapman; Cynthia Stewart; Erin Kelly; Amir Hanna; David C Wilson; Elizabeth Tullis; Paul B Pencharz Journal: Am J Clin Nutr Date: 2005-02 Impact factor: 7.045
Authors: Scott C Bell; Marcus A Mall; Hector Gutierrez; Milan Macek; Susan Madge; Jane C Davies; Pierre-Régis Burgel; Elizabeth Tullis; Claudio Castaños; Carlo Castellani; Catherine A Byrnes; Fiona Cathcart; Sanjay H Chotirmall; Rebecca Cosgriff; Irmgard Eichler; Isabelle Fajac; Christopher H Goss; Pavel Drevinek; Philip M Farrell; Anna M Gravelle; Trudy Havermans; Nicole Mayer-Hamblett; Nataliya Kashirskaya; Eitan Kerem; Joseph L Mathew; Edward F McKone; Lutz Naehrlich; Samya Z Nasr; Gabriela R Oates; Ciaran O'Neill; Ulrike Pypops; Karen S Raraigh; Steven M Rowe; Kevin W Southern; Sheila Sivam; Anne L Stephenson; Marco Zampoli; Felix Ratjen Journal: Lancet Respir Med Date: 2019-09-27 Impact factor: 30.700