ESPE2024 Poster Category 2 Diabetes and Insulin (35 abstracts)
Endocrine Evaluation in Patients with Cystic Fibrosis: A Retrospective Study from Single Tertiary Center
Mert Uçar 1 , Hande Turan 1 , Azer Kılıç Başkan 2 , Hasan Karakaş 1 , İlayda Altun 1 , Gökçe Velioğlu Haşlak 1 , Dilek Bingöl Aydın 1 , Ayşe Ayzıt Kılınç 2 , Olcay Evliyaoğlu 1 & Elvan Bayramoğlu 1
1Istanbul University Cerrahpaşa Medical School, Department of Pediatric Endocrinology, Istanbul, Turkey. 2Istanbul University Cerrahpaşa Medical School, Department of Pediatric Pulmonology, Istanbul, Turkey
Objectives: The incidence and importance of endocrine comorbidities related to cystic fibrosis-related diabetes (CFRD) and bone diseases (CFRBD) increase with age. Recent studies have indicated that insulin deficiency in type 1 diabetes mellitus(T1D) may be associated with an increased risk of osteoporosis. Our study aims to evaluate the relationship between glucose metabolism and bone health in pediatric cystic fibrosis patients.
Methods: The medical records of 74 CF patients were retrospectively reviewed. Demographic and clinical data were analyzed. Based on OGTT results the cases were divided into groups: normal, indeterminate, impaired glucose tolerance (IGT) and CFRD.
Results: 67.5% of patients were in normal,9.5% in indeterminate,16.2% in IGT and 6.8% in the CFRD group. The demographic and clinical characteristics of the groups are shown in Table 1: BMI SD(P <0.001), insulin levels (P = 0.011) and DEXA-z scores(P <0.001) were significantly higher in normal group compared to others. HbA1c levels were higher in the CFRD group compared to the normal group(P = 0.01) and similar to IGT and indetermine groups. There was positive correlation between fasting insulin levels and DEXA z-scores(P = 0.08, r =334).
| Total (n = 74) | Normal (n = 50,%67,5) | Indetermine (n = 7,%9,5) | IGT (n = 12,%16,2) | CFRD (n = 5,%6,8) | p value | |
| Age | 14.9±3.9 | 14.5±4.1 | 16.8±3.3 | 15.2±3.2 | 15±3.6 | 0.529 |
| Height SDS | -0.67±1.2 | -0.5±1.2 | -1±1.1 | -0.9±1.2 | -0.7±2 | 0.853 |
| BMI SDS | -0.6±1.5 | 0.1±1.2 | -2.2±1.2 | -1.3±0.9 | -1.7±0.7 | <0.001 |
| FPG(mg/dl) | 74.1±10 | 72.4±8.8 | 76.5±10.5 | 78.5±12.4 | 76.7±12.4 | 0.327 |
| Insulin | 5.8 (1.7; 9) | 7 (3.1; 10.3) | 3.3 (0.4; 8.5) | 3.6 (0.7; 6) | 2.2 (1.6; 2.6) | 0.011 |
| C-peptid(ng/ml) | 2±1.2 | 2.2±1.2 | 1.63±1.17 | 1.8±1.5 | 1.5±0.9 | 0.411 |
| HbA1c | 5.5±0.6 | 5.3±0.5 | 5.7±0.5 | 5.8±0.7 | 6±0.2 | 0.01 |
| Calcium(mg/dl) | 9.4±0.4 | 9.5±0.3 | 9.4±0.3 | 9.1±0.5 | 9.3±0.5 | 0.063 |
| Phosphorus (mg/dl) | 4.2±0.6 | 4.2±0.5 | 4.4±0.5 | 3.8±0.6 | 4.5±0.6 | 0.098 |
| PTH(pg/ml) | 40.3±15.2 | 38±12.2 | 36.1±22 | 50.3±12.2 | 32±20.3 | 0.071 |
| 25OHD(mcg/l) | 24.3±12.1 | 24.1±12.1 | 22.6±13.2 | 25±12.1 | 28±15.7 | 0.88 |
| DEXA | -1.3±0.9 | -1±0.8 | -1.9±0.7 | -2±0.7 | -1.87±1.1 | <0.001 |
Conclusion: In conclusion, it has been considered that insulin deficiency related osteoporosis which has been shown in T1D may contribute to CFRBD. Impaired glucose metabolism in CF patients is related to higher HbA1c levels but decreased BMI SD and DEXA z-score. A prospective and large-scale study is needed to demonstrate the relationship between CFRD and CFRBD.
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