青年囊性纤维化肝病患者与非囊性纤维化肝病患者的糖代谢特征:一项初步研究

IF 4.2 Q1 ENDOCRINOLOGY & METABOLISM
Maria Socorro Rayas , Kara S. Hughan , Rida Javaid , Andrea Kelly , Marzieh Salehi
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引用次数: 3

摘要

背景:糖尿病和肝脏疾病是囊性纤维化(CF)的危及生命的并发症。CF-肝脏疾病是CF相关性糖尿病(CFRD)发展的危险因素,但连接这两种合并症的潜在机制尚不清楚。本初步研究的目的是表征青年CF伴和不伴肝脏疾病的糖代谢。方法在这项双中心横断面研究中,20名伴有或不伴有肝脏疾病的青年CF患者接受了3小时口服葡萄糖耐量试验。受试者按肝病(LD)状况[无LD、轻度LD、重度LD]和糖尿病状况进行分类。测量葡萄糖漂移,胰岛细胞分泌反应,胰岛素敏感性和清除率。结果重度LD患者在CFRD患者中空腹、峰值和曲线下葡萄糖面积(AUC3h)最高(相互作用p <0.05)。与血糖变化平行,严重LD患者的膳食β-细胞分泌反应(AUC c -肽3h)低于轻度或无LD患者(p <0.01)。与无LD患者相比,重度LD患者HOMA-IR升高(p = 0.1),轻、重度LD患者空腹胰岛素清除率降低(p = 0.06),重度LD合并CFRD患者空腹胰岛素清除率降低(相互作用p = 0.1)。结论在这个小队列中,重度LD患者的血糖、胰岛素分泌、胰岛素敏感性和清除率更容易受损。更大规模的研究是必要的,以确定发病机制,为临床护理指南提供关于CFRD筛查、诊断和治疗方案的信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characterization of glucose metabolism in youth with vs. without cystic fibrosis liver disease: A pilot study

Background

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.

Methods

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.

Results

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).

Conclusion

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.

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来源期刊
CiteScore
6.10
自引率
0.00%
发文量
24
审稿时长
16 weeks
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