Glucose Tolerance in Patients with Cystic Fibrosis - Results from the German Cystic Fibrosis Registry

Prinz, Nicole; Wosniok, Julia; Staab, Doris; Ballmann, Manfred; Dopfer, Christian; Regenfuss, Nicole; Rosenecker, Josef; Schramm, Dirk; Holl, Reinhard W. und Naehrlich, Lutz (2020): Glucose Tolerance in Patients with Cystic Fibrosis - Results from the German Cystic Fibrosis Registry. In: Klinische Pädiatrie, Bd. 232, Nr. 04: S. 210-216

Abstract

BackgroundOral glucose tolerance (OGT) deteriorates progressively in cystic fibrosis (CF). Clinical registries provide a unique basis to study real-world data. Patients & methodsOGT tests (OGTTs) documented in the German CF-registry in 2016 were classified according WHO, modified by ADA: normal glucose tolerance (NGT), indeterminate glycaemia (INDET), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG+IGT, diabetes mellitus (DM). To study the association with lung function, multivariable regression adjusted for age, sex, and CFTR mutation was performed. ResultsOverall, OGTT screening was done in 35% of CF patients >= 10 years. Of the 996 patients (46.4% females;median age (IQR): 19 (14-27) years) with evaluable OGTTs, 56.2% had either NGT or INDET, whereas 34% had a pre-diabetic OGTT (IFG;IGT;IFG+IGT) and 9.8% a diabetic OGTT. 7 patients had glucose tolerance abnormalities <10 years. DM was more common in females or patients with F508del homozygote mutation, whereas IFG was more frequent in males (all p<0.05). Nearly 75% of patients after transplantation and about half with enteral/parental nutrition and/or steroid use had either a pre-diabetic or diabetic glucose tolerance. In the adjusted model, age (p<0.001) and OGTT category (p=0.013) had both a significant impact on %FEV1. ConclusionOur data of the German CF-registry highlights incidence of glucose tolerance abnormalities in second decade of life in CF patients. However, it also underlines the need for improvement of the documentation and/or performance of OGTT screening in real-world CF care.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0300-8630
• Sprache: Englisch