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Early glucose abnormalities are associated with pulmonary inflammation in young children with cystic fibrosis.
- Source :
-
Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [J Cyst Fibros] 2019 Nov; Vol. 18 (6), pp. 869-873. Date of Electronic Publication: 2019 Apr 26. - Publication Year :
- 2019
-
Abstract
- Background: Children with CF are insulin deficient from infancy but very little is known about the impact of glucose abnormalities in early life. We aimed to identify and describe interstitial glucose levels in CF children <6 years and to evaluate the association with pulmonary infection and inflammation.<br />Methods: We assessed 18 children (5 females) with median age of 3.2 years (range 0·9-5.5) with Continuous Glucose Monitoring for 3 days. Bronchoalveolar lavage (BAL) fluid was cultured for known pathogenic microbial agents and assessed for total white blood cells, percentage of neutrophils and IL-8 level.<br />Results: Peak sensor glucose (SG) was >11.1 mmol/L in 39% of participants. The percentage neutrophil count on BAL was positively correlated with elevated SG (peak SG r <subscript>s</subscript> = 0.48, p = .044) and with glucose variability (SG standard deviation r = 0.62, β = 38.5, p = .006). BAL IL-8 level was significantly correlated with all measures of CGM hyperglycemia including % time > 7.8 mmol/L (p = .008) and standard deviation (p < .001). Participants with a history of Pseudomonas aeruginosa had a higher % time > 7.8 mmol/L glucose (16% versus 3%, p = .015).<br />Conclusion: Children with CF frequently demonstrate elevated SG levels before age 6 years, which are associated with increased pulmonary inflammation and Pseudomonas aeruginosa infection. Transient SG elevations into the diabetic range (≥11.1 mmol/L) were identified in children from 1 year of age.<br /> (Crown Copyright © 2019. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Australia epidemiology
Blood Glucose analysis
Child, Preschool
Correlation of Data
Female
Humans
Infant
Interleukin-8 analysis
Leukocyte Count methods
Male
Monitoring, Physiologic methods
Monitoring, Physiologic statistics & numerical data
Bronchoalveolar Lavage Fluid immunology
Bronchoalveolar Lavage Fluid microbiology
Cystic Fibrosis blood
Cystic Fibrosis diagnosis
Cystic Fibrosis epidemiology
Cystic Fibrosis microbiology
Hyperglycemia diagnosis
Hyperglycemia immunology
Neutrophils
Pneumonia blood
Pneumonia diagnosis
Pseudomonas Infections blood
Pseudomonas Infections diagnosis
Pseudomonas aeruginosa isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1873-5010
- Volume :
- 18
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society
- Publication Type :
- Academic Journal
- Accession number :
- 31036487
- Full Text :
- https://doi.org/10.1016/j.jcf.2019.03.010