Progression of structural lung disease on CT scans in children with cystic fibrosis related diabetes.
BACKGROUND
Diabetes has a deleterious effect on clinical status in children with Cystic Fibrosis (CF). We hypothesized that children with CF Related Diabetes (CFRD) or Impaired Glucose Tolerance (IGT) would have more rapidly progressive lung disease based on chest computed tomography (CT) than those with normal glucose tolerance (NGT).


METHODS
In a retrospective study we compared lung structure changes over time, as assessed by CT, in 34 CF children with CFRD, IGT or NGT. We then compared CT findings with changes in lung function.


RESULTS
Percentage forced expiratory volume in 1s (%FEV1) remained stable over time with a mean (±SD) yearly change of -0.5% (±3.9), -0.4% (±2.3) and -0.85% (±2.8) (p=0.92) for the CFRD, IGT and NGT groups respectively. However, there was a mean (95%CI) increase in % CT score of 3.86%/year (1.77-5.95%), 1.59%/year (0.6-2.58%) and 1.09%/year (0.07-2.11%) (p=0.023).


CONCLUSIONS
In patients with CFRD, there was a more rapid progression of structural lung disease, compared to those who had NGT that was not reflected by change in lung function.
Department of Respiratory Medicine, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC 3052 Australia. jwidger1@yahoo.com
John
J
Widger
Sarath
S
Ranganathan
Philip J
PJ
Robinson
D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D003920:Diabetes Mellitus / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed