未经证实:糖尿病和肝病是囊性纤维化(CF)的危及生命的并发症。CF-肝病是CF相关糖尿病(CFRD)发展的危险因素,但这两种合并症的潜在联系机制尚不清楚。这项初步研究的目的是表征患有和不患有肝病的CF的年轻人的葡萄糖代谢。
未经评估:在这项双中心横截面研究中,20名患有和不患有肝病的CF的年轻人接受了3小时的口服葡萄糖耐量试验。受试者按肝病(LD)状态分类[无LD,轻度LD,严重的LD]和糖尿病状态。葡萄糖漂移的测量,胰岛细胞分泌反应,获得了胰岛素敏感性和清除率.
未经证实:患有严重LD的参与者禁食最高,峰值,CFRD个体在3小时内的曲线下的葡萄糖面积(AUC3h)(相互作用p<0.05)。在血糖变化的同时,与轻度或无LD相比,重度LD患者的餐时β细胞分泌反应(AUCC肽3h)较低(p<0.01)。重度LD患者的HOMA-IR较高(p=0.1),轻度和重度LD患者的空腹胰岛素清除率低于无LD患者(p=0.06),重度LD患者的餐时胰岛素清除率较低。CFRD(相互作用p=0.1)。
未经评估:在这个小组中,患有严重LD的受试者往往有更多的血糖受损,胰岛素分泌,胰岛素敏感性和清除率。更大规模的研究是必要的,以定义发病机制,以告知临床护理指南在CFRD筛选方面,诊断,和治疗选择。
UNASSIGNED: Diabetes and liver disease are life-threatening complications of cystic fibrosis (CF). CF-liver disease is a risk factor for CF related diabetes (CFRD) development, but the underlying mechanisms linking the two co-morbidities are not known. The objective of this pilot study was to characterize glucose metabolism in youth with CF with and without liver disease.
UNASSIGNED: In this two-center cross-sectional study, 20 youth with CF with and without liver disease underwent a 3-hour oral glucose tolerance test. Subjects were categorized by liver disease (LD) status [no LD, mild LD, severe LD] and diabetes status. Measures of glucose excursion, islet cell secretory responses, insulin sensitivity and clearance were obtained.
UNASSIGNED: Participants with severe LD had the highest fasting, peak, and glucose area under the curve over 3 h (AUC3h) among individuals with CFRD (interaction p < 0.05). In parallel with glycemic changes, prandial β-cell secretory response (AUC C-peptide 3h) was lower in those with severe LD compared to mild or no LD (p < 0.01). There was a trend of higher HOMA-IR in those with severe LD (p = 0.1) as well as lower fasting insulin clearance in those with mild and severe LD compared to no LD (p = 0.06) and lower prandial insulin clearance in severe LD among those with CFRD (interaction p = 0.1).
UNASSIGNED: In this small cohort, subjects with severe LD tended to have more impaired glycemia, insulin secretion, insulin sensitivity and clearance. Larger studies are imperative to define the pathogenesis to inform clinical care guidelines in terms of CFRD screening, diagnosis, and treatment options.