Early glucose abnormalities revealed by continuous glucose monitoring associate with lung function decline in cystic fibrosis: A five-year prospective study.

Autor: Rakotoarisoa L; Department of Endocrinology, Diabetes and Nutrition, Strasbourg University Hospital, France; Adult Cystic Fibrosis Centre, Strasbourg University Hospital, France; UMR Inserm 1260, Regenerative Nanomedicine, University of Strasbourg, France., Weiss L; Pediatric Cystic Fibrosis Centre, Strasbourg University Hospital, France., Lefebvre F; Group of Methodology in Clinical Research (GMRC), Strasbourg University Hospital, France., Porzio M; Adult Cystic Fibrosis Centre, Strasbourg University Hospital, France; Department of Pneumology, Strasbourg University Hospital, France., Renaud-Picard B; Adult Cystic Fibrosis Centre, Strasbourg University Hospital, France; UMR Inserm 1260, Regenerative Nanomedicine, University of Strasbourg, France; Department of Pneumology, Strasbourg University Hospital, France., Ravoninjatovo B; Cystic Fibrosis Centre, Reims University Hospital Centre, France., Abely M; Cystic Fibrosis Centre, Reims University Hospital Centre, France., Danner-Boucher I; Cystic Fibrosis Centre, Nantes University Hospital, France., Dubois S; Cystic Fibrosis Centre, Angers University Hospital, France., Troussier F; Cystic Fibrosis Centre, Angers University Hospital, France., Prevotat A; Cystic Fibrosis Centre, Lille University Hospital, France., Rault G; Cystic Fibrosis Centre of Perharidy, Roscoff, France., Kessler R; Adult Cystic Fibrosis Centre, Strasbourg University Hospital, France; UMR Inserm 1260, Regenerative Nanomedicine, University of Strasbourg, France; Department of Pneumology, Strasbourg University Hospital, France., Kessler L; Department of Endocrinology, Diabetes and Nutrition, Strasbourg University Hospital, France; Adult Cystic Fibrosis Centre, Strasbourg University Hospital, France; UMR Inserm 1260, Regenerative Nanomedicine, University of Strasbourg, France. Electronic address: luc.rakotoarisoa@chru-strasbourg.fr.
Jazyk: angličtina
Zdroj: Journal of diabetes and its complications [J Diabetes Complications] 2024 Apr; Vol. 38 (4), pp. 108703. Date of Electronic Publication: 2024 Feb 14.
DOI: 10.1016/j.jdiacomp.2024.108703
Abstrakt: Background: Cystic fibrosis related diabetes (CFRD) is commonly associated with declining lung function and nutritional status. We aimed to evaluate the pulmonary impact of early glucose abnormalities by using 2-h standard oral glucose tolerance testing (OGTT) and continuous glucose monitoring (CGM) in people with cystic fibrosis (PwCF).
Methods: PwCF aged ≥10 years old without known CFRD were included in a five-year prospective multicentre study. Annual evaluation of nutritional status, lung function, OGTT and CGM was set up. Associations between annual rate changes (Δ) in lung function, ΔFEV1 (forced expiratory volume in 1 s) percentage predicted (pp) and ΔFVC (forced vital capacity) pp., and annual rate changes in OGTT or CGM variables were estimated with a mixed model with a random effect for subject.
Results: From 2009 to 2016, 112 PwCF (age: 21 ± 11 years, BMI (body mass index) z-score: -0.55 ± 1.09, FEV1pp: 77 ± 24 %, 2-h OGTT glucose: 122 ± 44 mg/dL, AUC (area under curve) >140 mg/dL: 1 mg/dL/day (0.2, 3.0) were included. A total of 428 OGTTs and 480 CGMs were collected. The participants presented annual decline of FVCpp and FEV1pp at -1.0 % per year (-1.6, -0.4), p < 0.001 and - 1.9 % per year (-2.5, -1.3), p < 0.001 respectively without change in BMI z-score during the study. Variation of two-hour OGTT glucose was not associated with declining lung function, as measured by ΔFEV1pp (p = 0.94) and ΔFVCpp (p = 0.90). Among CGM variables, only increase in AUC >140 mg/dL between two annual visits was associated with a decrease in ΔFVCpp (p < 0.05) and ΔFEV1pp (p < 0.05).
Conclusions: This prospective study supports the fact that early glucose abnormalities revealed by CGM predict pulmonary function decline in PwCF, while 2-h standard OGTT glucose is not associated with pulmonary impairment.
Competing Interests: Declaration of competing interest No potential conflicts of interest relevant to this article were reported.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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