Early glucose abnormalities are associated with pulmonary inflammation in young children with cystic fibrosis.
J Cyst Fibros
; 18(6): 869-873, 2019 11.
Article
en En
| MEDLINE
| ID: mdl-31036487
ABSTRACT
BACKGROUND:
Children with CF are insulin deficient from infancy but very little is known about the impact of glucose abnormalities in early life. We aimed to identify and describe interstitial glucose levels in CF children <6â¯years and to evaluate the association with pulmonary infection and inflammation.METHODS:
We assessed 18 children (5 females) with median age of 3.2â¯years (range 0·9-5.5) with Continuous Glucose Monitoring for 3â¯days. Bronchoalveolar lavage (BAL) fluid was cultured for known pathogenic microbial agents and assessed for total white blood cells, percentage of neutrophils and IL-8 level.RESULTS:
Peak sensor glucose (SG) was >11.1â¯mmol/L in 39% of participants. The percentage neutrophil count on BAL was positively correlated with elevated SG (peak SG rsâ¯=â¯0.48, pâ¯=â¯.044) and with glucose variability (SG standard deviation râ¯=â¯0.62, ßâ¯=â¯38.5, pâ¯=â¯.006). BAL IL-8 level was significantly correlated with all measures of CGM hyperglycemia including % timeâ¯>â¯7.8â¯mmol/L (pâ¯=â¯.008) and standard deviation (pâ¯<â¯.001). Participants with a history of Pseudomonas aeruginosa had a higher % timeâ¯>â¯7.8â¯mmol/L glucose (16% versus 3%, pâ¯=â¯.015).CONCLUSION:
Children with CF frequently demonstrate elevated SG levels before age 6â¯years, which are associated with increased pulmonary inflammation and Pseudomonas aeruginosa infection. Transient SG elevations into the diabetic range (≥11.1â¯mmol/L) were identified in children from 1â¯year of age.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Neumonía
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Pseudomonas aeruginosa
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Infecciones por Pseudomonas
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Líquido del Lavado Bronquioalveolar
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Fibrosis Quística
/
Hiperglucemia
/
Neutrófilos
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Child, preschool
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Female
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Humans
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Infant
/
Male
País/Región como asunto:
Oceania
Idioma:
En
Revista:
J Cyst Fibros
Año:
2019
Tipo del documento:
Article