Journal of Clinical and Translational Endocrinology最新文献

{"title":"Coronary artery disease in patients with cystic fibrosis – A case series and review of the literature","authors":"Zahrae Sandouk ,&nbsp;Noura Nachawi ,&nbsp;Richard Simon ,&nbsp;Jennifer Wyckoff ,&nbsp;Melissa S. Putman ,&nbsp;Sarah Kiel ,&nbsp;Sarah Soltman ,&nbsp;Antoinette Moran ,&nbsp;Amir Moheet","doi":"10.1016/j.jcte.2022.100308","DOIUrl":"10.1016/j.jcte.2022.100308","url":null,"abstract":"<div><p>Progressive obstructive pulmonary disease is the primary life-shortening complication in people with Cystic Fibrosis (CF); improvement in life expectancy has led to increased prevalence of non-pulmonary complications. Patients with CF are considered to be at<!--> <!-->low risk for coronary artery disease (CAD). We<!--> <!-->report here a case series of six patients with CF with and without known cystic fibrosis related diabetes (CFRD) who had acute myocardial infarction (AMI) requiring coronary stent placement. This was a heterogeneous group of patients, without a clear pattern of consistent risk factors. Interestingly, most patients in this cohort had low LDL. In this review, we discuss risk factors of cardiovascular disease (CVD) that may apply to the CF population. While CAD is rare in people with CF, it does occur. We postulate that the risk will grow with increased longevity and the increased prevalence of co-morbidities such as obesity and dyslipidemia.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/60/main.PMC9576554.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40647477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of real-world evidence data to evaluate the comparative effectiveness of second-line type 2 diabetes medications on chronic kidney disease","authors":"Yu Deng ,&nbsp;Farhad Ghamsari ,&nbsp;Alice Lu ,&nbsp;Jingzhi Yu ,&nbsp;Lihui Zhao ,&nbsp;Abel N. Kho","doi":"10.1016/j.jcte.2022.100309","DOIUrl":"10.1016/j.jcte.2022.100309","url":null,"abstract":"<div><p>Chronic kidney disease (CKD) is a common complication of type 2 diabetes mellitus (T2DM). Approximately-one-third of patients with T2DM also have CKD. In clinical trial studies, several anti-diabetic medications (ADM) show evidence of preventing the progression of CKD. Biguanides (e.g., metformin) are widely accepted as the first line medication. However, the comparative effectiveness of second line ADMs on CKD outcomes in T2DM is unclear. In addition, results from clinical trials may not generalize into routine clinical practice. In this study, we aimed to investigate the association of second line ADMs with diagnosed incident CKD, CKD hospitalization, and eGFR &lt; 45 mL/min in T2DM patients using real-world data from electronic health records. Our study found that treatment with sodium-glucose cotransporter 2 <strong>(</strong>SGLT-2) inhibitors was significantly associated with lower risk of diagnosed CKD incidence in both primary analysis (hazard ratio, 0.43; 95 % CI, [0.22;0.87]; p-value,0.02) and secondary analysis (hazard ratio, 0.42; 95 % CI, [0.19;0.92]; p-value, 0.03) compared to use of Sulfonylureas (SU) as a second-line ADM. However, significant associations were not observed when using eGFR &lt; 45 mL/min as the endpoint. Treatment with a dipeptidyl peptidase 4 (DPP-4) inhibitor was significantly associated with lower risk of diagnosed incident CKD (hazard ratio, 0.7; 95 % CI, [0.53;0.96]; p-value, 0.03) and lower risk of CKD hospitalization (hazard ratio, 0.6; 95 % CI, [0.37; 0.96]; p-value, 0.04) in the primary analysis. However, both associations were not significant in the sensitivity analysis. We did not observe significant association between use of glucagon-like peptide 1 receptor agonists (GLP-1RA), Thiazolidinediones (TZD), insulin and diagnosed CKD incidence, hospitalization or eGFR &lt; 45 mL/min compared to use of SU as a second-line ADM.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d1/c9/main.PMC9816064.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9535508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of continuous glucose monitoring to reference standard oral glucose tolerance test for the detection of dysglycemia in cystic Fibrosis: A systematic review","authors":"Shanal Kumar ,&nbsp;Michael Pallin ,&nbsp;Georgia Soldatos ,&nbsp;Helena Teede","doi":"10.1016/j.jcte.2022.100305","DOIUrl":"10.1016/j.jcte.2022.100305","url":null,"abstract":"<div><h3>Aims</h3><p>Increasing evidence for benefit of early detection of cystic fibrosis related diabetes (CFRD) coupled with limitations of current diagnostic investigations has led to interest and utilisation of continuous glucose monitoring (CGM). We conducted a systematic review to assess current evidence on CGM compared to reference standard oral glucose tolerance test for the detection of dysglycemia in people with cystic fibrosis without confirmed diabetes.</p></div><div><h3>Methods</h3><p>MEDLINE, Embase, CENTRAL, Evidence-Based Medicine Reviews, grey literature and six relevant journals were searched for studies published after year 2000. Studies reporting contemporaneous CGM metrics and oral glucose tolerance test results were included. Outcomes on oral glucose tolerance tests were categorised into a) normal, b) abnormal (indeterminate and impaired) or c) diabetic as defined by American Diabetes Association criteria. CGM outcomes were defined as hyperglycemia (≥1 peak sensor glucose ≥ 200 mg/dL), dysglycemia (≥1 peak sensor glucose ≥ 140–199 mg/dL) or normoglycemia (all sensor glucose peaks &lt; 140 mg/dL). CGM hyperglycemia in people with normal or abnormal glucose tolerances was used to define an arbitrary CGM-diagnosis of diabetes. The Quality Assessment of Diagnostic Accuracy Studies tool was used to assess risk of bias. Primary outcome was relative risk of an arbitrary CGM-diagnosis of diabetes compared to the oral glucose tolerance test.</p></div><div><h3>Results</h3><p>We identified 1277 publications, of which 19 studies were eligible comprising total of 416 individuals with contemporaneous CGM and oral glucose tolerance test results. Relative risk of an arbitrary CGM-diagnosis of diabetes compared to oral glucose tolerance test was 2.92. Studies analysed were highly heterogenous, prone to bias and inadequately assessed longitudinal associations between CGM and relevant disease-specific sequela.</p></div><div><h3>Conclusions</h3><p>A single reading &gt; 200 mg/dL on CGM is not appropriate for the diagnosis of CFRD. Prospective studies correlating CGM metrics to disease-specific outcomes are needed to determine appropriate cut-points.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/a9/main.PMC9529501.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33489338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of cystic fibrosis transmembrane conductance regulator modulators on impaired glucose tolerance and cystic fibrosis related diabetes","authors":"Sana Hasan ,&nbsp;Mohammad Salman Khan ,&nbsp;M. Cecilia Lansang","doi":"10.1016/j.jcte.2022.100301","DOIUrl":"10.1016/j.jcte.2022.100301","url":null,"abstract":"<div><p>Cystic fibrosis (CF) is an autosomal recessive disorder, with a prevalence of 1 in 2,500 live births. It is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. With the significant advancement in CFTR-directed therapies, life expectancy of CF patients has steadily increased. With improved survival, CF related co-morbidities have become more apparent. The most common endocrine complication includes Cystic fibrosis related diabetes (CFRD). Impaired glucose tolerance and insulin deficiency in CFRD leads to a decline in pulmonary function in CF patients. Here we review the underlying mechanisms involved in the pathogenesis of CFRD, focusing on the role of CFTR in the regulation of insulin secretion from the β-cell. We then discuss CFTR modulators and their effect on impaired glucose tolerance and CFRD.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/2c/main.PMC9209718.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40390256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ZnT8 autoantibody prevalence is low in youth with type 2 diabetes and associated with higher insulin sensitivity, lower insulin secretion, and lower disposition index","authors":"Janine Higgins ,&nbsp;Philip Zeitler ,&nbsp;Kimberly L. Drews ,&nbsp;Silva Arslanian ,&nbsp;Kenneth Copeland ,&nbsp;Robin Goland ,&nbsp;Georgeanna Klingensmith ,&nbsp;Terri H. Lipman ,&nbsp;Sherida Tollefsen ,&nbsp;for the TODAY Study Group","doi":"10.1016/j.jcte.2022.100300","DOIUrl":"10.1016/j.jcte.2022.100300","url":null,"abstract":"<div><h3>Aim</h3><p>ZnT8 autoantibody positivity (ZnT8+) is associated with risk for type 1 diabetes and with metabolic complications in adults. Our aim was to assess prevalence of ZnT8 + in the Treatment of T2D in Adolescents and Youth (TODAY) cohort and describe associated phenotypic outcomes.</p></div><div><h3>Methods</h3><p>TODAY participants were 13.98 ± 2.03 years with a confirmed diagnosis of T2D, BMI percentile of 97.69 ± 3.32 (64% female), and GAD- and IA2- at baseline. ZnT8 autoantibodies were measured at baseline and end of study.</p></div><div><h3>Results</h3><p>3 of 687 participants (0.29%) were ZnT8 + and there was one conversion (0.15%) from ZnT8- to ZnT8 + during the study. ZnT8A + individuals had higher HbA1c, HDL and LDL cholesterol, and IL-1β concentrations, and lower BMI, IL-6, and triglyceride concentrations compared to the TODAY cohort and ZnT8A- individuals. They also had higher insulin sensitivity with lower insulin secretion and disposition index, metabolically resembling T1D. All ZnT8 + participants experienced loss of glycemic control on randomized treatment, but exhibited lower rates of diabetic complications than other groups.</p></div><div><h3>Conclusion</h3><p>Given the low rate of complications in ZnT8 + individuals, ZnT8 likely does not impact the clinical course of the disease in this population.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/9f/main.PMC9120949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10243308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyslipidemia in South African patients with hypothyroidism","authors":"Brett S. Mansfield ,&nbsp;Sindeep Bhana ,&nbsp;Frederick J. Raal","doi":"10.1016/j.jcte.2022.100302","DOIUrl":"10.1016/j.jcte.2022.100302","url":null,"abstract":"<div><h3>Background</h3><p>Overt hypothyroidism leads to increased cardiovascular risk, primarily through effects the disorder has on lipids. Most studies investigating lipids in the setting of hypothyroidism, have been performed in predominantly Caucasians in North America and Europe. Different patterns and prevalence of dyslipidemia have been described; one study reporting dyslipidemia in 90% of patients with hypothyroidism. The prevalence of dyslipidemia in overt hypothyroidism among the ethnically diverse predominantly black South African population is unknown.</p></div><div><h3>Methodology</h3><p>A retrospective case-control study evaluating lipid profiles of an ethnically diverse cohort of patients with overt hypothyroidism (TSH &gt; 10 mIU/L) attending two academic hospitals in Johannesburg, South Africa from September 2006–September 2016. Patients with primary or secondary causes for dyslipidemia and those taking lipid-lowering therapy were excluded.</p></div><div><h3>Results</h3><p>Two hundred and six patients with hypothyroidism were included and compared to 412 euthyroid controls matched for sex, ethnicity, and age. Most hypothyroid patients were female (n = 180;67.5 %). Median TSH was similar across all ethnic groups (p = 0.09). Median TC, TG and LDL-C were higher in hypothyroid patients (p &lt; 0.01). Normal lipid profiles were found in 29.44 % of all hypothyroid patients. However, a greater proportion, 47 of 124 (37.90 %), black African patients with hypothyroidism had a normal lipid profile.</p></div><div><h3>Conclusion</h3><p>Dyslipidemia is less common in black African patients with hypothyroidism. This is probably due to this population group being in an earlier stage of epidemiologic transition. Those with hypothyroidism were at greater overall cardiovascular risk based on TC/HDL-C ratio but did not reach high risk atherogenic profiles reported in previous studies.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/fc/main.PMC9309410.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40554104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considering the impact of patient ethnicity on cystic fibrosis related bone disease","authors":"Mahsa Kabuli ,&nbsp;Amir Reza Akbari ,&nbsp;Benyamin Alam","doi":"10.1016/j.jcte.2022.100303","DOIUrl":"10.1016/j.jcte.2022.100303","url":null,"abstract":"","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/17/main.PMC9344016.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40694803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-8, CXCL10, CXCL11 and their role in insulin resistance in adult females with subclinical hypothyroidism and prediabetes","authors":"Roxana Adriana Stoica ,&nbsp;Nicoleta Drăgana ,&nbsp;Robert Ancuceanu ,&nbsp;Ovidiu Ionuț Geicu ,&nbsp;Cristian Guja ,&nbsp;Anca Pantea-Stoian ,&nbsp;Damaris-Cristina Gheorghe ,&nbsp;Raluca-Ioana Stefan-van Staden ,&nbsp;Cristian Serafinceanu ,&nbsp;Adrian Costache ,&nbsp;Constantin Ionescu-Tîrgoviște","doi":"10.1016/j.jcte.2022.100299","DOIUrl":"10.1016/j.jcte.2022.100299","url":null,"abstract":"<div><p>In obesity, the hormonal secretion of the thyroid gland switches from homeostasis to type 2 allostasis in order to adapt to persistent modifications of adipose tissue and inflammation. Previous meta-analyses have linked obesity with an increased risk of developing thyroid diseases, prediabetes, and type 2 diabetes mellitus. We designed an observational cross-sectional study including all female patients presenting consecutively in an ambulatory clinic for 16 months. This study aimed to describe the level of serum cytokines and chemokines in relation to TSH, fT4 and insulin resistance (IR) indexes in patients with subclinical hypothyroidism (SCH). The study included 72 women with a median age of 59 ± 17.75 years, and a mean BMI (Body Mass Index) of 31.48 ± 6.75 kg/m². Modelling homeostasis model assessment of IR indices (HOMA-IR) based on chemokines (IL-8, CXCL10, CXCL11, leptin), C-reactive protein, the presence or absence of SCH, taking into account age, BMI, abdominal circumference, glycated haemoglobin (HbA1c), and anti-thyroid peroxidase antibodies (ATPO) as covariates, identified a single chemokine that was significantly associated with the dependent variable (IL-8). IR indices are negatively associated with IL-8 in female patients with subclinical hypothyroidism, but the effect of the cytokine is minimal. BMI rather than TSH influences the level of CXCL11 in our population. CXCL10 has a tendency to increase in patients with SCH, obesity and prediabetes, with no association with TSH.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214623722000072/pdfft?md5=7553f997b3b57015a1c27c8728a187c2&pid=1-s2.0-S2214623722000072-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43304269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice versus guidelines for the screening of cystic fibrosis-related diabetes: A French survey from the 47 centers","authors":"Laurence Weiss ,&nbsp;Olivia Ronsin ,&nbsp;Quitterie Reynaud ,&nbsp;Michel Abely ,&nbsp;Laurent Mely ,&nbsp;Pierre-Régis Burgel ,&nbsp;Jacques Beltrand ,&nbsp;Laurence Kessler","doi":"10.1016/j.jcte.2022.100298","DOIUrl":"10.1016/j.jcte.2022.100298","url":null,"abstract":"<div><p>This study aimed to analyze clinical practices concerning cystic fibrosis-related diabetes (CFRD) screening in France. A web-based questionnaire was distributed between December 1, 2020 and January 31, 2021 among 47 cystic fibrosis centers including pediatric, adult, and mixed units. In accordance with guidelines, 92.8% of CF centers performed annual oral glucose tolerance tests (OGTT). Overall, 86.3% of CF centers performed 1- and 2-hour blood glucose determinations following OGTT. The OGTT was conducted before 10 years of age in 73% of pediatric centers. Continuous glucose monitoring (CGM) and laboratory glycated hemoglobin were employed for CFRD screening in 86.5% and 50% of centers, respectively. CGM was carried out in 69% of centers after glucose tolerance abnormalities had been detected in OGTT. Most CF centers used OGTT and CGM for CFRD screening. Studies are required to assess CGM usefulness as a validated tool in CFRD screening.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214623722000060/pdfft?md5=c6ae918f7c8c6247a678efb230158d51&pid=1-s2.0-S2214623722000060-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42739765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of glucose metabolism in youth with vs. without cystic fibrosis liver disease: A pilot study","authors":"Maria Socorro Rayas ,&nbsp;Kara S. Hughan ,&nbsp;Rida Javaid ,&nbsp;Andrea Kelly ,&nbsp;Marzieh Salehi","doi":"10.1016/j.jcte.2022.100296","DOIUrl":"10.1016/j.jcte.2022.100296","url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>Participants with severe LD had the highest fasting, peak, and glucose area under the curve over 3 h (AUC_3h) among individuals with CFRD (interaction p &lt; 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 &lt; 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).</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214623722000047/pdfft?md5=039f7c6dc09aec5d16a5f5eb3df27cd1&pid=1-s2.0-S2214623722000047-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42299737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}