根据俄罗斯联邦2021年囊性纤维化患者登记,儿童期囊性纤维化依赖型糖尿病患者的特征

IF 0.7 Q4 ENDOCRINOLOGY & METABOLISM
Diabetes Mellitus Pub Date : 2023-10-23 DOI:10.14341/dm13064
E. I. Kondratyeva, A. I. Tlif, A. Yu. Voronkova, E. L. Amelina, N. Yu. Kashirskaya, S. A. Krasovsky, M. A. Starinova, T. L. Kuraeva
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The study included 122 patients with diabetes mellitus requiring the use of insulin — 33 children (27%) and 89 adults (73%), the average age of children was 13.5±4.1, the average age of adult. patients aged 18 years and older was 27.4±6.6. To compare the course of cystic fibrosis in patients with and without diabetes mellitus, groups were formed that were comparable in age, gender, genotype — the group of patients without diabetes included 827 patients, 33 patients made up the group of patients with CFRD using insulin. Diagnostic criteria, indicators of respiratory function, microbiological status, nature of complications, volume of therapy were compared. RESULTS : Patients with CFRD have a lower FEV1 compared to children without diabetes mellitus — M±SD FEV1 (%) 85.2±27.5 in the group of patients without diabetes mellitus and M±SD FEV1 (%) 72.4±26.0 in patients with diabetes mellitus (p < 0.016), compared in the microbiological seeding groups — a trend towards more frequent chronic growth of Pseudomonas aeruginosa 54.50% versus 39.4% in the group without CFRD. An increase in MRSA was also more often detected — 9.1% compared with the group of children without diabetes — 3.1%. Antibacterial therapy is more commonly used — inhaled in 54.6% of patients without diabetes mellitus while children with CFRD received inhaled antibiotic therapy in 75.8% (p=0.017). There was a significant difference in the used antibacterial tablet therapy (p=0.013). A significant difference in the number of patients on oxygen therapy in the group with CFRD — 12.1%, versus 3.4% without CFRD (p=0.01) confirms a more severe course of cystic fibrosis in patients with CFRD. CONCLUSION : The prevalence of CFDM with the need for insulin therapy among children in the Russian Federation is 1.3%. 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引用次数: 0

摘要

背景:近几十年来,CF患者的预期寿命增加,这导致与碳水化合物代谢受损相关的疾病频率增加。目的:根据俄罗斯联邦(RF) 2021年囊性纤维化患者登记册,分析儿童和青少年囊性纤维化相关糖尿病(CFDM)对囊性纤维化病程的影响。材料与方法:分析俄罗斯联邦2021年囊性纤维化患者登记数据。本研究纳入122例需要使用胰岛素的糖尿病患者,其中儿童33例(27%),成人89例(73%),儿童平均年龄13.5±4.1岁,成人平均年龄。18岁及以上患者为27.4±6.6。为了比较合并和不合并糖尿病患者囊性纤维化的病程,我们组成了年龄、性别、基因型具有可比性的组——无糖尿病患者组包括827例患者,使用胰岛素的CFRD患者组包括33例患者。比较两组患者的诊断标准、呼吸功能指标、微生物状况、并发症性质、治疗量。结果:CFRD患儿FEV1低于无糖尿病患儿,无糖尿病组M±SD FEV1(%)为85.2±27.5,糖尿病组M±SD FEV1(%)为72.4±26.0 (p <0.016),与微生物播种组相比,铜绿假单胞菌的慢性生长趋势更为频繁,在没有CFRD的组中为54.50%,而在没有CFRD的组中为39.4%。与没有糖尿病的儿童组相比,MRSA的检出率也增加了3.1%,增加了9.1%。抗菌药物的使用更为普遍,无糖尿病患者中吸入抗生素的比例为54.6%,而CFRD患儿中吸入抗生素的比例为75.8% (p=0.017)。使用抗菌片剂治疗两组间差异有统计学意义(p=0.013)。在CFRD组中,接受氧疗的患者人数有12.1%的显著差异,而无CFRD组为3.4% (p=0.01),证实了CFRD患者的囊性纤维化病程更严重。结论:俄罗斯联邦儿童中需要胰岛素治疗的CFDM患病率为1.3%。囊性纤维化相关性糖尿病在肺功能、革兰氏阴性菌群和耐药菌群的生长、严重并发症的出现以及频繁使用抗生素治疗等方面均显著加重囊性纤维化病程,这与发展为囊性纤维化相关性糖尿病患者囊性纤维化支气管肺过程的频繁加重明显相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characteristics of patients with cystic fibrosis-dependent diabetes mellitus in childhood according to the register of patients with cystic fibrosis of the Russian Federation in 2021
BACKGROUND : In recent decades, the life expectancy of patients with CF has increased, which leads to an increase in the frequency of conditions associated with impaired carbohydrate metabolism. AIM : to analyze the impact of cystic fibrosis-associated diabetes mellitus (CFDM) in children and adolescents on the course of cystic fibrosis according to the 2021 register of patients with cystic fibrosis of the Russian Federation (RF). MATERIALS AND METHODS : the data of the register of patients with cystic fibrosis of the Russian Federation for 2021 were analyzed. The study included 122 patients with diabetes mellitus requiring the use of insulin — 33 children (27%) and 89 adults (73%), the average age of children was 13.5±4.1, the average age of adult. patients aged 18 years and older was 27.4±6.6. To compare the course of cystic fibrosis in patients with and without diabetes mellitus, groups were formed that were comparable in age, gender, genotype — the group of patients without diabetes included 827 patients, 33 patients made up the group of patients with CFRD using insulin. Diagnostic criteria, indicators of respiratory function, microbiological status, nature of complications, volume of therapy were compared. RESULTS : Patients with CFRD have a lower FEV1 compared to children without diabetes mellitus — M±SD FEV1 (%) 85.2±27.5 in the group of patients without diabetes mellitus and M±SD FEV1 (%) 72.4±26.0 in patients with diabetes mellitus (p < 0.016), compared in the microbiological seeding groups — a trend towards more frequent chronic growth of Pseudomonas aeruginosa 54.50% versus 39.4% in the group without CFRD. An increase in MRSA was also more often detected — 9.1% compared with the group of children without diabetes — 3.1%. Antibacterial therapy is more commonly used — inhaled in 54.6% of patients without diabetes mellitus while children with CFRD received inhaled antibiotic therapy in 75.8% (p=0.017). There was a significant difference in the used antibacterial tablet therapy (p=0.013). A significant difference in the number of patients on oxygen therapy in the group with CFRD — 12.1%, versus 3.4% without CFRD (p=0.01) confirms a more severe course of cystic fibrosis in patients with CFRD. CONCLUSION : The prevalence of CFDM with the need for insulin therapy among children in the Russian Federation is 1.3%. Cystic fibrosis-associated diabetes mellitus significantly worsens the course of cystic fibrosis in terms of lung function, the growth of gram-negative and resistant flora, the presence of severe complications and the frequent use of antibiotic therapy, which is obviously associated with frequent exacerbations of the bronchopulmonary process in cystic fibrosis in patients with developed cystic fibrosis-associated diabetes mellitus.
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来源期刊
Diabetes Mellitus
Diabetes Mellitus ENDOCRINOLOGY & METABOLISM-
CiteScore
1.90
自引率
40.00%
发文量
61
审稿时长
7 weeks
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