title: Insulin secretion abnormalities in exocrine pancreatic sufficient cystic fibrosis patients.
abstract: BACKGROUND
  The aim of this study is to assess insulin secretion in pediatric cystic fibrosis (CF) patients with exocrine pancreatic sufficiency.
  
  
  METHODS
  Glucose and insulin responses during an oral glucose tolerance test (OGTT) were measured in 146 CF patients. Patients were divided into exocrine sufficient (CF-PS) and insufficient (CF-PI) groups based on pancreatic enzyme usage and fecal elastase. A reference group included healthy, non-diabetic subjects.
  
  
  RESULTS
  All CF groups showed reduced insulin secretion as measured by insulinogenic index. The CF-PS patients had normal glucose tolerance. There was a direct correlation between BMI z-score and insulin area under the curve.
  
  
  CONCLUSIONS
  Patients with CF have reduced insulin secretion during an OGTT regardless of exocrine pancreatic status. The abnormal insulin secretion in all CF patients may predispose them for glucose intolerance, particularly when challenged by inflammation, infection, or nutritional deficiency. In addition, the diminished insulin secretion may contribute to increased catabolism. Lastly, the CF-related diabetes (CFRD) screening guidelines should be followed by all CF patients regardless of pancreatic status.
authors.affiliation: Department of Pediatrics, St. Louis University School of Medicine, St. Louis, MO 63104, United States. Electronic address: jwooldr4@slu.edu.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Wooldridge
authors.affiliation: Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States.
authors.forename: Rhonda D
authors.initials: RD
authors.lastname: Szczesniak
authors.affiliation: Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Fenchel
authors.affiliation: Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Elder
mesh_terms: D000293:Adolescent; D002648:Child; D003550:Cystic Fibrosis / Q000378:metabolism*; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion; D008297:Male; D046790:Pancreas, Exocrine / Q000378:metabolism*
chemical_list: D007328:Insulin
keywords: Anabolism; Hyperglycemia; Insulin deficiency; Insulin-secreting cells; Pancreatic cystic fibrosis