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Insulin secretion, nutritional status and respiratory function in cystic fibrosis patients with normal glucose tolerance.
MedLine Citation:
PMID:  21974813     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Impaired growth and nutritional status in CF may be related to progressive insulin deficiency before CF-Related Diabetes has established. Aim of this study was to analyse the association of circulating insulin with nutritional status and lung function in CF patients with normal glucose tolerance (NGT). METHODS: We performed OGTT in 152 consecutive CF patients aged 8-20 years: 115 of them had NGT and were included in the study. Areas under the curves (AUC) of glucose, insulin and c-peptide after 120 min were calculated. Quartiles (Q) of increasing fasting insulin (fINS-Q) and c-peptide (fCP-Q) levels were calculated in CF patients. Respiratory function parameters (FEV1, FVC), Standard Deviation Scores (SDS) of height, weight and BMI were compared between Q1 and the three higher Q. Multiple regression analysis was used to analyse the association of fasting insulin, c-peptide or OGTT derived indices with nutritional or respiratory parameters. RESULTS: Compared to patients in fINS-Q4 or fCP-Q4, those in fINS-Q1 or in fCP-Q1 respectively showed lower levels of insulin AUC or c-peptide AUC (both P < 0.0001), weight-SDS (P = 0.013, P = 0.007), BMI-SDS (P = 0.010, P = 0.002), FEV1 (P = 0.076, P = 0.013) and FVC (P = 0.101, P = 0.009). Age- and gender-adjusted regression analysis showed significant associations of fINS and fCP with SDS of BMI (P = 0.023 and P = 0.001 respectively), fCP was significant associated with FEV1 (P = 0.01). AUC insulin/AUC glucose ratio (P < 0.0001) and AUC c-peptide/AUC glucose ratio (P = 0.0001) were significantly associated with FEV1. CONCLUSIONS: Insulin deficiency in CF patients with NGT has a significant impact on clinical outcomes.
Authors:
Gianfranco Alicandro; Pier Maria Battezzati; Alberto Battezzati; Chiara Speziali; Laura Claut; Valentina Motta; Silvana Loi; Carla Colombo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-3
Journal Detail:
Title:  Clinical nutrition (Edinburgh, Scotland)     Volume:  -     ISSN:  1532-1983     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309603     Medline TA:  Clin Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Affiliation:
Department of Paediatrics, Cystic Fibrosis Center of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Commenda 9, 20122 Milan, Italy.
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