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The 1-h oral glucose tolerance test glucose and insulin values are associated with markers of clinical deterioration in cystic fibrosis

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Abstract

Aims

Cystic fibrosis (CF) is associated with the emergence of CF-related diabetes (CFRD). CFRD is associated with increased risk of accelerated weight and/or lung function loss (clinical degradation). Data in the CF pediatric population reported an association between higher 60-min oral glucose tolerance test (OGTT) plasma glucose values and reduced lung function. Our objective was to evaluate the relationship between the 60-min OGTT insulin and glucose values and markers of clinical degradation in adult patients with CF.

Methods

This study was based on an ongoing observational cohort of CF adult patients (≥18 years). All patients underwent a 2-h OGTT with 30-min interval sample measurements. Plasma insulin and glucose levels were measured. Adult patients (N = 240) were categorized based on the 60-min OGTT median values of glucose (G60, 11.0 mmol/L) and/or insulin (I60, 43.4 μU/mL).

Results

A negative association was observed between the 60-min OGTT glucose value and pulmonary function (FEV1; P = 0.001), whereas 60-min OGTT insulin values were positively associated with BMI (P = 0.004). Patients with high G60 values displayed lower FEV1 than patients with low G60 values (P = 0.025). Patients with higher I60 values demonstrated higher values of both FEV1 (P = 0.022) and BMI (P = 0.003) than patients with low I60 values. More importantly, when adjusting for BMI, the difference in FEV1 between both groups no longer existed (P = 0.166).

Conclusions

Both insulin and glucose values at 60-min OGTT are associated with indicators of clinical degradation in adult patients with CF. Future prospective analyses are essential in establishing the clinical utility of these indicators.

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Abbreviations

CF:

Cystic fibrosis

CFRD:

CF-related diabetes

HbA1c:

Glycated hemoglobin

OGTT:

Oral glucose tolerance test

G60-G120:

OGTT plasma glucose values at 60 and 120 min

I0-I60-I120:

OGTT plasma insulin values at 0, 60 and 120 min

CHUM:

Centre Hospitalier de l’Université de Montréal

AUC:

Area under the curve

INDET:

Indeterminate glucose tolerance

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Acknowledgments

We thank the CF and diabetes clinic nurses for OGTT coordination.

Author information

Authors and Affiliations

  1. Institut de recherches cliniques de Montréal, 110 avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada

    Adèle Coriati, Sophie Ziai, Yves Berthiaume & Rémi Rabasa-Lhoret

  2. Department of Nutrition, Université de Montréal, Montréal, QC, H3T 1A8, Canada

    Adèle Coriati, Sophie Ziai & Rémi Rabasa-Lhoret

  3. Cystic Fibrosis Clinic of the Centre hospitalier de l’Université de Montréal, Montréal, QC, H2W 1T8, Canada

    Annick Lavoie, Yves Berthiaume & Rémi Rabasa-Lhoret

  4. Department of Medicine, Université de Montréal, Montréal, QC, H3T 1J4, Canada

    Yves Berthiaume & Rémi Rabasa-Lhoret

Authors
  1. Adèle Coriati
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  2. Sophie Ziai
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  4. Yves Berthiaume
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  5. Rémi Rabasa-Lhoret
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Corresponding author

Correspondence to Adèle Coriati.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Funding sources

This study is supported by the J-A DeSève chair for clinical research to RRL and by an operating team grant from the Canadian Cystic Fibrosis Foundation (No. 18608) to RRL and YB. AC holds the Michel Bélanger PhD scholarship from the Institut de Recherches Cliniques de Montréal (IRCM). RRL holds a scholarship from the Fonds de Recherche en Santé du Québec, and SZ has a doctoral Banting and Best scholarship from the Canadian Institutes of Health Research.

Ethical standard

All human studies have been reviewed and approved by the Research Ethics Committee of the CHUM.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Coriati, A., Ziai, S., Lavoie, A. et al. The 1-h oral glucose tolerance test glucose and insulin values are associated with markers of clinical deterioration in cystic fibrosis. Acta Diabetol 53, 359–366 (2016). https://doi.org/10.1007/s00592-015-0791-3

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  • DOI: https://doi.org/10.1007/s00592-015-0791-3

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