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Influence of pre-diabetic and pancreatic exocrine states on pulmonary and nutritional status in adults with Cystic Fibrosis.
- Source :
-
Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [J Cyst Fibros] 2021 Sep; Vol. 20 (5), pp. 803-809. Date of Electronic Publication: 2021 Jan 19. - Publication Year :
- 2021
-
Abstract
- Background: In 1992, a landmark study demonstrated clinical deterioration in respiratory function and nutritional status prior to the onset of cystic fibrosis-related diabetes (CFRD). We re-evaluated this outcome.<br />Methods: The Montreal Cystic Fibrosis Cohort is a prospective CFRD screening study. We performed a 6-year retrospective analysis of nutritional parameters and FEV <subscript>1</subscript> (%) in subjects who developed incident CFRD and in controls who maintained normoglycemia (NG). In the former group, data was collected over 6 years prior to diabetes onset.<br />Results: Subjects (n = 86) had a mean age of 31.7 ± 8.1 years, BMI of 23.0 ± 4.0 kg/m2, and FEV1% of 70.1 ± 24.2%. Eighty-one percent had pancreatic insufficiency (PI). Patients were grouped as follows: NG+PS (pancreatic sufficient) (n = 16), NG+PI (pancreatic insufficient) (n = 21), CFRD+PS (n = 3) and CFRD+PI (n = 46). At their most recent screen NG+PS subjects had significantly greater BMI, as compared to NG+PI and CFRD+PI groups (26.2 ± 3.6 kg/m <superscript>2</superscript> vs 22.6 ± 4.2 kg/m <superscript>2</superscript> vs 22.1 ± 3.5 kg/m <superscript>2</superscript> , p = 0.0016). FEV <subscript>1</subscript> was significantly greater in the NG+PS group (91.5 ± 16.8% vs 67.8 ± 25.3% vs 63.5 ± 22.2%, p = 0.0002). The rates of change in weight, BMI, fat mass (%), and FEV <subscript>1</subscript> prior to the most recent visit (NG+PS, NG+PI groups) or to the diagnosis of de novo CFRD were similar between groups.<br />Conclusion: In a contemporary context, CFRD onset is not preceded by deterioration in BMI, fat mass, or pulmonary function. Low BMI and FEV <subscript>1</subscript> are more closely associated with PI than a pre-diabetic state.<br />Competing Interests: Declaration of Competing Interest None.<br /> (Copyright © 2020. Published by Elsevier B.V.)
Details
- Language :
- English
- ISSN :
- 1873-5010
- Volume :
- 20
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society
- Publication Type :
- Academic Journal
- Accession number :
- 33353861
- Full Text :
- https://doi.org/10.1016/j.jcf.2020.11.022