Premium
Ventilation inhomogeneity is associated with OGTT‐derived insulin secretory defects in cystic fibrosis
Author(s) -
Colombo Carla,
Alicandro Gianfranco,
Gambazza Simone,
Mileto Palmiro,
Mari Andrea,
Grespan Eleonora,
Nazzari Erica,
Russo Maria Chiara,
Battezzati Alberto
Publication year - 2019
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24212
Subject(s) - medicine , cystic fibrosis , cystic fibrosis related diabetes , diabetes mellitus , interquartile range , spirometry , endocrinology , insulin , gastroenterology , cardiology , insulin resistance , impaired glucose tolerance , asthma
Progressive deterioration of β‐cell function is the main mechanism underlying diabetes in cystic fibrosis (CF). Diabetes negatively impacts the clinical status of CF patients years before its onset. We aimed to evaluate if OGTT‐derived indices of β‐cell function are associated with early markers of lung disease. We carried out a cross‐sectional study on 80 CF patients who performed OGTT, spirometry, and nitrogen‐multiple breath washout test. β‐cell glucose sensitivity and the insulinogenic indices were used as markers of β‐cell function and first‐phase insulin response to glucose stimulus. We used sex‐ and age‐adjusted multiple linear regression models to estimate the association between OGTT‐derived indices and lung function measures. An increment of β‐cell glucose sensitivity equal to its interquartile range was associated with an increase in ppFEV 1 of 7.6 points (95%CI: 0.8; 14.4) as well as with a decrease in LCI of −1.96 units (95%CI: −3.40; −0.51) and in S cond of −0.016 L −1 (95%CI: −0.026; −0.007). The corresponding figures for insulinogenic index were: 8.6 (95%CI: 3.4; 13.9) for ppFEV 1 , −2.03 (95%CI: −3.13; −0.94) for LCI, and −0.014 L −1 (95%CI: −0.021; −0.071) for S cond . When adjusting also for 2‐h plasma glucose, both β‐cell glucose sensitivity and insulinogenic index remained inversely associated with S cond . Deterioration of β‐cell function is related to early lung disease in young patients with mild to normal pulmonary function. This relationship is independent from hyperglycemia and mainly involves conductive airways.