Characterization of glucose metabolism in youth with vs. without cystic fibrosis liver disease: A pilot study
Background: Diabetes and liver disease are life-threatening complications of cystic fibrosis (CF). CF-liver disease is a risk factor for CF related diabetes (CFRD) development, but the underlying mechanisms linking the two co-morbidities are not known. The objective of this pilot study was to charac...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Journal of Clinical & Translational Endocrinology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214623722000047 |
| _version_ | 1828379759128608768 |
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| author | Maria Socorro Rayas Kara S. Hughan Rida Javaid Andrea Kelly Marzieh Salehi |
| author_facet | Maria Socorro Rayas Kara S. Hughan Rida Javaid Andrea Kelly Marzieh Salehi |
| author_sort | Maria Socorro Rayas |
| collection | DOAJ |
| description | Background: Diabetes and liver disease are life-threatening complications of cystic fibrosis (CF). CF-liver disease is a risk factor for CF related diabetes (CFRD) development, but the underlying mechanisms linking the two co-morbidities are not known. The objective of this pilot study was to characterize glucose metabolism in youth with CF with and without liver disease. Methods: In this two-center cross-sectional study, 20 youth with CF with and without liver disease underwent a 3-hour oral glucose tolerance test. Subjects were categorized by liver disease (LD) status [no LD, mild LD, severe LD] and diabetes status. Measures of glucose excursion, islet cell secretory responses, insulin sensitivity and clearance were obtained. Results: Participants with severe LD had the highest fasting, peak, and glucose area under the curve over 3 h (AUC3h) among individuals with CFRD (interaction p < 0.05). In parallel with glycemic changes, prandial β-cell secretory response (AUC C-peptide 3h) was lower in those with severe LD compared to mild or no LD (p < 0.01). There was a trend of higher HOMA-IR in those with severe LD (p = 0.1) as well as lower fasting insulin clearance in those with mild and severe LD compared to no LD (p = 0.06) and lower prandial insulin clearance in severe LD among those with CFRD (interaction p = 0.1). Conclusion: In this small cohort, subjects with severe LD tended to have more impaired glycemia, insulin secretion, insulin sensitivity and clearance. Larger studies are imperative to define the pathogenesis to inform clinical care guidelines in terms of CFRD screening, diagnosis, and treatment options. |
| first_indexed | 2024-12-10T03:45:35Z |
| format | Article |
| id | doaj.art-5ea413e78c2c4208bf26380225089de3 |
| institution | Directory Open Access Journal |
| issn | 2214-6237 |
| language | English |
| last_indexed | 2024-12-10T03:45:35Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical & Translational Endocrinology |
| spelling | doaj.art-5ea413e78c2c4208bf26380225089de32022-12-22T02:03:26ZengElsevierJournal of Clinical & Translational Endocrinology2214-62372022-06-0128100296Characterization of glucose metabolism in youth with vs. without cystic fibrosis liver disease: A pilot studyMaria Socorro Rayas0Kara S. Hughan1Rida Javaid2Andrea Kelly3Marzieh Salehi4Division of Pediatric Endocrinology and Diabetes, University of Texas Health San Antonio, 7703 Floyd Curl, San Antonio, TX 78229, USA; Corresponding author.Division of Pediatric Endocrinology and Diabetes, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 4401 Penn Avenue, Pittsburgh, PA 15224, USADivision of Pediatric Endocrinology and Diabetes, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 4401 Penn Avenue, Pittsburgh, PA 15224, USADivision of Pediatric Endocrinology and Diabetes, Children's Hospital of Philadelphia, Perelman School of Medicine of University of Pennsylvania, 2716 South Street, Philadelphia, PA 19146, USADivision of Diabetes, University of Texas Health San Antonio, 7703 Floyd Curl, San Antonio, TX 78229, USA; Audie Murphy Hospital, STVHCS, 7703 Floyd Curl, San Antonio, TX 78229, USABackground: Diabetes and liver disease are life-threatening complications of cystic fibrosis (CF). CF-liver disease is a risk factor for CF related diabetes (CFRD) development, but the underlying mechanisms linking the two co-morbidities are not known. The objective of this pilot study was to characterize glucose metabolism in youth with CF with and without liver disease. Methods: In this two-center cross-sectional study, 20 youth with CF with and without liver disease underwent a 3-hour oral glucose tolerance test. Subjects were categorized by liver disease (LD) status [no LD, mild LD, severe LD] and diabetes status. Measures of glucose excursion, islet cell secretory responses, insulin sensitivity and clearance were obtained. Results: Participants with severe LD had the highest fasting, peak, and glucose area under the curve over 3 h (AUC3h) among individuals with CFRD (interaction p < 0.05). In parallel with glycemic changes, prandial β-cell secretory response (AUC C-peptide 3h) was lower in those with severe LD compared to mild or no LD (p < 0.01). There was a trend of higher HOMA-IR in those with severe LD (p = 0.1) as well as lower fasting insulin clearance in those with mild and severe LD compared to no LD (p = 0.06) and lower prandial insulin clearance in severe LD among those with CFRD (interaction p = 0.1). Conclusion: In this small cohort, subjects with severe LD tended to have more impaired glycemia, insulin secretion, insulin sensitivity and clearance. Larger studies are imperative to define the pathogenesis to inform clinical care guidelines in terms of CFRD screening, diagnosis, and treatment options.http://www.sciencedirect.com/science/article/pii/S2214623722000047Liver diseaseDiabetesOral glucose tolerance testInsulin resistanceHepatic insulin clearanceCystic fibrosis |
| spellingShingle | Maria Socorro Rayas Kara S. Hughan Rida Javaid Andrea Kelly Marzieh Salehi Characterization of glucose metabolism in youth with vs. without cystic fibrosis liver disease: A pilot study Journal of Clinical & Translational Endocrinology Liver disease Diabetes Oral glucose tolerance test Insulin resistance Hepatic insulin clearance Cystic fibrosis |
| title | Characterization of glucose metabolism in youth with vs. without cystic fibrosis liver disease: A pilot study |
| title_full | Characterization of glucose metabolism in youth with vs. without cystic fibrosis liver disease: A pilot study |
| title_fullStr | Characterization of glucose metabolism in youth with vs. without cystic fibrosis liver disease: A pilot study |
| title_full_unstemmed | Characterization of glucose metabolism in youth with vs. without cystic fibrosis liver disease: A pilot study |
| title_short | Characterization of glucose metabolism in youth with vs. without cystic fibrosis liver disease: A pilot study |
| title_sort | characterization of glucose metabolism in youth with vs without cystic fibrosis liver disease a pilot study |
| topic | Liver disease Diabetes Oral glucose tolerance test Insulin resistance Hepatic insulin clearance Cystic fibrosis |
| url | http://www.sciencedirect.com/science/article/pii/S2214623722000047 |
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