Liver disease as risk factor for cystic fibrosis-related diabetes development.
OBJECTIVE
To evaluate clinical and genetic factors, besides pancreatic insufficiency, associated with increased risk of cystic fibrosis-related diabetes.


METHODS
Case-control (1:1) study on 138 cystic fibrosis patients. Data were collected on gender, age at diagnosis, reason for cystic fibrosis diagnosis, family history of type 1 or 2 diabetes mellitus, pre-existing severe liver disease, and class of cystic fibrosis transmembrane regulation mutation. Moreover, information was obtained on lung involvement and degree of exocrine pancreatic insufficiency evaluated 1 year before the diagnosis of cystic fibrosis-related diabetes in patients and age-matched controls.


RESULTS
Compared to controls, patients with cystic fibrosis-related diabetes had a higher probability of having already been diagnosed with liver disease (16.7% versus 1.7%, OR = 11.6, 95% CI 1.43-93.0). Moreover, in the year before diabetes onset, cases had slightly worse pulmonary function compared to controls (FEV1 = 58.4 +/- 27% predicted versus 67.4 +/- 21% predicted; p = 0.05). No significant effects related to the other factors considered were found.


CONCLUSIONS
Severe liver disease was found to significantly increase the risk of developing cystic fibrosis-related diabetes. Patients with liver disease should be scheduled for earlier diabetes screening in order to identify and possibly treat glucose intolerance.
Minicucci
L
L
Cystic Fibrosis Center, Pediatric Clinics University of Genova, G. Gaslini Children Hospital, Genova, Italy. lauraminicucci@ospedale-gaslini.ge.it
Lorini
R
R
Giannattasio
A
A
Colombo
C
C
Iapichino
L
L
Reali
M F
MF
Padoan
R
R
Calevo
M G
MG
Casciaro
R
R
De Alessandri
A
A
Haupt
R
R
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D003550:Cystic Fibrosis / Q000453:epidemiology* / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology*; D012307:Risk Factors