title: Intermittent hyperglycemia due to autonomic nervous system dysfunction: a new feature in patients with congenital central hypoventilation syndrome.
abstract: OBJECTIVE
  To analyze glycemic profile in children with congenital central hypoventilation syndrome, which is characterized by autonomic nervous system dysfunction.
  
  
  METHODS
  We carried out a university hospital-based observational study. Participants included 14 patients assessed from 2007 to 2009 with a median age of 7.6 (25th-75th percentiles, 1.5-9.6) years at the time of the study. Glucose metabolism was assessed by calculating 24-hour plasma glucose (before and after meals) and fasting insulin concentrations and carrying out an oral glucose tolerance test (OGTT). The main outcome measure was the proportion of patients with abnormal glucose concentrations.
  
  
  RESULTS
  Abnormal plasma glucose concentrations were found in 6 (43%) of the 14 patients with high fasting (n = 1) or postprandial (n = 5) hyperglycemia. OGTT was performed in 8 patients, of whom 3 (38%) had impaired glucose tolerance. Indices of insulin resistance and secretion were normal. No difference in clinical aspects relating to the presence of affected organs and/or systems related to central nervous system dysfunction, age, or auxology findings was found between patients with normal (43%) and abnormal (57%) glucose homeostasis over a 24-hour glycemia cycle or OGTT.
  
  
  CONCLUSIONS
  This study provides new information about glucose homeostasis in congenital central hypoventilation syndrome, revealing a high incidence of hyperglycemia and expanding the spectrum of the disease. It highlights the link between autonomic nervous system dysfunction and glycemic dysregulation. Regular, long-term monitoring of glucose metabolism is recommended in these patients.
authors.affiliation: Pediatric Endocrinology Service, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Paris, France.
authors.forename: Georges
authors.initials: G
authors.lastname: Gelwane
authors.forename: Ha
authors.initials: H
authors.lastname: Trang
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Carel
authors.forename: Stéphane
authors.initials: S
authors.lastname: Dauger
authors.forename: Juliane
authors.initials: J
authors.lastname: Léger
mesh_terms: D000293:Adolescent; D001342:Autonomic Nervous System Diseases / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D007040:Hypoventilation / Q000150:complications / Q000151:congenital*; D007223:Infant; D008297:Male; D011446:Prospective Studies; D020182:Sleep Apnea, Central / Q000150:complications*