title: Diagnosis of cystic fibrosis-related glucose abnormalities: Can we shorten the standard oral glucose tolerance test?
abstract: Adult patients with cystic fibrosis (APCF) are at high risk of developing impaired glucose tolerance (IGT) and CF-related diabetes (CFRD) and thus an annual screening with a 2-h oral glucose tolerance test (OGTT) is recommended. This population would greatly benefit from a simplified and harmless alternative to the standard OGTT. Thus, we aimed to compare the diagnostic values of HbA1c and glycemias at interval time points during the 2-h OGTT for IGT and CFRD detection in APCF. To do so, we conducted a cross-sectional analysis of 194 APCF with normal fasting plasma glucose values (≤ 7.0 mmol · L(-1)) who underwent a 2-h OGTT. Receivers operating characteristic area under the curves (ROC-AUC) were analyzed to assess the diagnostic value of HbA1c and intermediate OGTT glycemias using 2-h OGTT glycemia as reference. For both IGT and CFRD diagnoses, ROC-AUC values obtained from glycemia at 90 min were significantly higher than HbA1c and remaining intermediate glycemias (p < 0.001). The best 90-min OGTT cut-off values for these diagnoses were >9.3 mmol · L(-1) (IGT) and ≥ 11.5 mmol · L(-1) (CFRD). A 90-min OGTT glycemia might be a simplified alternative to 2-h OGTT glycemia for earlier glucose tolerance abnormalities diagnosis in APCF. This finding should be confirmed in other APCF cohorts and its predictive value should be established prospectively.
authors.affiliation: Institut de Recherches Cliniques de Montréal, 110 Avenue Des Pins Ouest, Montréal, QC H2W 1R7, Canada.
authors.forename: Adèle
authors.initials: A
authors.lastname: Coriati
authors.forename: Belinda
authors.initials: B
authors.lastname: Elisha
authors.forename: Sandrine
authors.initials: S
authors.lastname: Virassamynaik
authors.forename: Maude
authors.initials: M
authors.lastname: Phaneuf
authors.forename: Sophie
authors.initials: S
authors.lastname: Ziai
authors.forename: Marie-Soleil
authors.initials: MS
authors.lastname: Gauthier
authors.forename: Rémi
authors.initials: R
authors.lastname: Rabasa-Lhoret
mesh_terms: D001786:Blood Glucose; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000097:blood; D005947:Glucose; D018149:Glucose Intolerance / Q000097:blood; D005951:Glucose Tolerance Test; D006801:Humans
chemical_list: D001786:Blood Glucose; D005947:Glucose