Glucose intolerance in patients with cystic fibrosis: sex-based differences in clinical score, pulmonary function, radiograph score, and 6-minute walk test.
OBJECTIVE
To determine the sex-specific relationships between glucose intolerance and Shwachman-Kulczycki clinical score, lung function, Brasfield chest-radiograph score, and exercise capacity in patients with cystic fibrosis (CF).


METHODS
We used a cross-sectional study design and included CF patients ≥ 10 years old. All patients had clinical and nutritional evaluation, oral glucose tolerance test, spirometry, chest radiograph, and 6-min walk test (6MWT). Patients were classified as having normal glucose tolerance, impaired glucose tolerance, or CF-related diabetes mellitus.


RESULTS
We included 88 patients: 59 with normal glucose tolerance, 15 with impaired glucose tolerance, and 14 with CF-related diabetes. Shwachman-Kulczycki clinical score (P = .04), at-rest S(pO(2)) (P = .001), S(pO(2)) difference before versus after 6MWT (P = .001), and Brasfield chest-radiograph score (P = .01) were significantly lower in the impaired-glucose-tolerance group than in the normal-glucose-tolerance group, but did not differ from the CF-related-diabetes group. In female patients only, percent-of-predicted FEV(1) was significantly lower in the impaired-glucose-tolerance group than in the normal-glucose-tolerance group (P = .02), but did not differ from the CF-related-diabetes group (P = .10). There was a significant relationship between glucose intolerance and sex when clinical score, 6-min walk distance, FEV(1), and radiograph score were combined in a multivariate analysis.


CONCLUSIONS
In patients with CF, glucose intolerance was associated with poor clinical score, lower at-rest S(pO(2)), greater S(pO(2)) difference before versus after 6MWT, poor lung function, and lower radiograph score. Overall, multivariate analysis indicated poorer performance in the latter variables in female patients with glucose intolerance than in male patients with glucose intolerance.
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. brunaziegler@yahoo.com.br
Bruna
B
Ziegler
Claudine Lacerda
CL
Oliveira
Paula Maria Eidt
PM
Rovedder
Sandra Jungblut
SJ
Schuh
Fernando Antônio
FA
Abreu E Silva
Paulo de Tarso Roth
Pde T
Dalcin
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D018149:Glucose Intolerance / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D011859:Radiography; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult