Continuous Glucose Monitoring and HbA1c in Cystic Fibrosis: Clinical Correlations and Implications for CFRD Diagnosis.

Autor:	Scully KJ; Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA.; Harvard Medical School, Boston MA, USA., Sherwood JS; Harvard Medical School, Boston MA, USA.; Diabetes Research Center, Massachusetts General Hospital, Boston, MA, USA., Martin K; Diabetes Research Center, Massachusetts General Hospital, Boston, MA, USA., Ruazol M; Diabetes Research Center, Massachusetts General Hospital, Boston, MA, USA., Marchetti P; Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA., Larkin M; Harvard Medical School, Boston MA, USA.; Diabetes Research Center, Massachusetts General Hospital, Boston, MA, USA., Zheng H; Harvard Medical School, Boston MA, USA.; Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA., Sawicki GS; Harvard Medical School, Boston MA, USA.; Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA., Uluer A; Harvard Medical School, Boston MA, USA.; Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA.; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA., Neuringer I; Harvard Medical School, Boston MA, USA.; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA., Yonker LM; Harvard Medical School, Boston MA, USA.; Division of Pediatric Pulmonary Medicine, Massachusetts General Hospital, Boston, MA, USA., Sicilian L; Harvard Medical School, Boston MA, USA.; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA., Wexler DJ; Harvard Medical School, Boston MA, USA.; Diabetes Research Center, Massachusetts General Hospital, Boston, MA, USA., Putman MS; Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA.; Harvard Medical School, Boston MA, USA.; Diabetes Research Center, Massachusetts General Hospital, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2022 Mar 24; Vol. 107 (4), pp. e1444-e1454.
DOI:	10.1210/clinem/dgab857
Abstrakt:	Context: The clinical utility and implications of continuous glucose monitoring (CGM) in cystic fibrosis (CF) are unclear. Objective: We examined the correlation between CGM measures and clinical outcomes in adults with CF, investigated the relationship between hemoglobin A1c (HbA1c) and CGM-derived average glucose (AG), and explored CGM measures that distinguish cystic fibrosis-related diabetes (CFRD) from normal and abnormal glucose tolerance. Methods: This prospective observational study included 77 adults with CF who had CGM and HbA1c measured at 2 to 3 time points 3 months apart. Results: Thirty-one of the 77 participants met American Diabetes Association-recommended diagnostic criteria for CFRD by oral glucose tolerance testing and/or HbA1c. In all participants, CGM measures of hyperglycemia and glycemic variability correlated with nutritional status and pulmonary function. HbA1c was correlated with AG (R2 = 0.71, P < 0.001), with no significant difference between this regression line and that previously established in type 1 and type 2 diabetes and healthy volunteers. Cutoffs of 17.5% time > 140 mg/dL and 3.4% time > 180 mg/dL had sensitivities of 87% and 90%, respectively, and specificities of 95%, for identifying CFRD. Area under the curve and percent of participants correctly classified with CFRD were higher for AG, SD, % time > 140, > 180, and > 250 mg/dL than for HbA1c. Conclusion: CGM measures of hyperglycemia and glycemic variability are superior to HbA1c in distinguishing those with and without CFRD. CGM-derived AG is strongly correlated with HbA1c in adults with CF, with a similar relationship to other diabetes populations. Future studies are needed to investigate CGM as a diagnostic and screening tool for CFRD. (© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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