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Glycemic control and FEV1 recovery during pulmonary exacerbations in pediatric cystic fibrosis-related diabetes.

小儿囊性纤维化相关糖尿病肺部加重期间的血糖控制和 FEV1 恢复。

  • 影响因子:2.88
  • DOI:10.1016/j.jcf.2019.12.016
  • 作者列表:"Okoniewski W","Hughan KS","Weiner GA","Weiner DJ","Forno E
  • 发表时间:2020-01-21
Abstract

RATIONALE:Whether short-term glucose control in cystic fibrosis-related diabetes (CFRD) is associated with FEV1 recovery during acute pulmonary exacerbations is unclear. METHODS:Data from all patients with CFRD ages 6-21 years hospitalized in 2010-2016 for pulmonary exacerbations at our CF Center were analyzed, including CFRD status at each encounter, all FEV1 recorded during each exacerbation, and relevant clinical covariates. Glucose control was analyzed using meter blood glucose area under the curve (AUC) indices. The primary outcome was FEV1 recovery. RESULTS:Patients with CFRD who finished IV antibiotics at home were treated for longer than those fully treated in the hospital (22.2 vs. 13.8 days). In those who finished treatment at home, poor inpatient glycemic control was associated with lower lung function improvement: when comparing the 75th to the 25th percentile of each glycemic index (i.e., "poorer" vs. "better" glycemic control), FEV1 recovery at discharge was 20.1% lower for glucose AUC (95%CI -0.4%, -39.9%); 20.9% lower for 48-h AUC (95%CI -2.7%, -39.1%); and 28.2% lower for AUC/day (95%CI -7.1%, -49.3%). Similar results were found at the end of IV antibiotics and at clinic follow-up. Likewise, patients with poor glycemic control had a lower slope of inpatient FEV1 recovery. Analysis in patients with normal glucose tolerance was largely non-significant. No associations were found between hemoglobin A1c and FEV1 recovery. CONCLUSIONS:In patients with CFRD who complete IV antibiotic treatment at home, poor inpatient glycemic control is associated with worse FEV1 recovery despite longer duration of treatment.

摘要

原理: 囊性纤维化相关糖尿病 (CFRD) 的短期血糖控制是否与急性肺加重期 FEV1 恢复相关尚不清楚。 方法: 分析我们 CF 中心 2010-2016 例因肺部加重住院的所有 6-21 岁 CFRD 患者的数据,包括每次就诊时的 CFRD 状态, 每次加重期间记录的所有 FEV1,以及相关的临床协变量。使用血糖仪血糖曲线下面积 (AUC) 指数分析血糖控制。主要结局为 FEV1 恢复。 结果: 在家完成静脉抗生素治疗的 CFRD 患者的治疗时间比在医院完全治疗的患者长 (22.2 vs.13.8 天)。在家中完成治疗的患者中,住院患者血糖控制不佳与肺功能改善较低相关: 当比较每个血糖指数的第 75 至第 25 百分位数时 (i。 e., “更差” vs.“更好” 血糖控制),出院时 FEV1 恢复为葡萄糖 AUC 低 20.1% (95% CI-0.4%,-39.9%); 48 h AUC 低 20.9% (95% CI-2.7%,-39.1%); AUC/天低 28.2% (95% CI-7.1%,-49.3%)。在 IV 抗生素结束时和临床随访时也发现了类似的结果。同样,血糖控制不佳的患者住院 FEV1 恢复的斜率较低。正常糖耐量患者的分析在很大程度上是不显著的。未发现血红蛋白 A1c 与 FEV1 恢复之间存在关联。 结论: 在在家中完成 IV 抗生素治疗的 CFRD 患者中,尽管治疗持续时间较长,但住院患者血糖控制不佳与 FEV1 恢复较差相关。

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翻译标题与摘要 下载文献
影响因子:4.40
发表时间:2020-01-01
DOI:10.1007/s00262-019-02431-8
作者列表:["Shibaki, Ryota","Murakami, Shuji","Matsumoto, Yuji","Yoshida, Tatsuya","Goto, Yasushi","Kanda, Shintaro","Horinouchi, Hidehito","Fujiwara, Yutaka","Yamamoto, Nobuyuki","Kusumoto, Masahiko","Yamamoto, Noboru","Ohe, Yuichiro"]

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影响因子:4.04
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作者列表:["Sousa SA","Soares-Castro P","Seixas AMM","Feliciano JR","Balugas B","Barreto C","Pereira L","Santos PM","Leitão JH"]

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