Document Detail


Identification of insulin secretory defects and insulin resistance during Oral Glucose Tolerance Test in a cohort of Cystic Fibrosis Patients.
MedLine Citation:
PMID:  21502328     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Cystic Fibrosis Related Diabetes (CFRD) is a leading complication of Cystic Fibrosis (CF) associated with pulmonary and nutritional deterioration years before evident hyperglycaemia, possibly because of insulin deficiency and resistance. Aim: To evaluate glucose tolerance, insulin secretion and sensitivity by a widely applicable method suitable for accurate and prospective measurements in a CF population. Methods: 165 CF subjects (80 females) aged 17±5 years and 18 age and sex matched healthy controls (CON) received OGTTs with glucose, insulin and c-peptide determinations. Insulin sensitivity was defined on the basis of glucose and insulin concentrations using the oral glucose insulin sensitivity (OGIS) index, whereas beta-cell function was determined on the basis of a model relating insulin secretion (c-peptide profile) to glucose concentration. Results: 15% of CF patients had glucose intolerance and 6% had diabetes without and 3% diabetes with fasting hyperglycaemia. Beta-cell function was reduced in CF patients compared to CON (70.0±4.1 vs 117.9±11.6 pmol min-1 m-2 mM-1, p<0.001) and decreased significantly with age by -2.7 pmol min-1 m-2 mM-1 per year (CI -4.5 to -0.82), almost 4%, yearly. The early insulin secretion index was also reduced. Insulin sensitivity was similar to CON. CF patients who attained glucose tolerance comparable to CON, had lower beta cell function and higher insulin sensitivity. Conclusion: The major alteration in insulin secretion and insulin sensitivity of CF patients is slowly declining beta-cell function, consisting of delayed and reduced responsiveness to hyperglycemia, that in CF patients with normal glucose tolerance may be compensated by increased insulin sensitivity.
Authors:
Alberto Battezzati; Andrea Mari; Laura Zazzeron; Gianfranco Alicandro; Laura Claut; Pier Maria Battezzati; Carla Colombo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-18
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
A Battezzati, International Center for the Assessment of Nutritional Status - DiSTAM, Università degli Studi di Milano, Milano, Italy.
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