Association of Islet Amyloid Polypeptide to C-Peptide Ratio With Cystic Fibrosis-Related Diabetes: A Prospective Cross-sectional Study.

OBJECTIVES: Early detection of cystic fibrosis (CF) related diabetes (CFRD) improves health outcomes and reduces CF-related mortality. The study aims to evaluate the ratio of islet amyloid polypeptide (IAPP) to C-peptide in CF patients with diabetes and without diabetes. METHODS: Cross-sectional analysis was carried out in a prospective cohort of 33 participants (CF [n = 16] and CFRD [n = 18]). We examined the association of plasma IAPP:C-peptide ratio with clinical information, including glycated hemoglobin, and lung function markers. RESULTS: The median (interquartile range) IAPP:C-peptide ratio was significantly (P = 0.004) higher in people with CFRD (4.8 [4.5]) compared with participants without CFRD (12.1 [19.7]). The ratio of IAPP to C-peptide significantly accounted for a 38% variation in the diabetes status in patients with CF (r2 = 0.399, P < 0.001). Islet amyloid polypeptide is strongly correlated with serum ferritin levels (r = 0.683, P = 0.005) and forced expiratory volume in CFRD, but not in nondiabetic participants with CF. CONCLUSIONS: Islet amyloid polypeptide:C-peptide ratio could be a potential marker of CFRD in adults with CF. Further research requires validation of this marker in longitudinal cohort studies to confirm the capability of IAPP:C-peptide to predict CFRD.

Pseudomonas pharyngitis in a cystic fibrosis patient.

We report a case of Pseudomonas pharyngitis in a cystic fibrosis (CF) patient not known to have prior colonization of Pseudomonas. We believe that this is one of the first cases of pseudomonas pharyngitis in a CF patient.

Occupationally acquired Pasteurella multocida pneumonia in a healthy abattoir worker.

An otherwise healthy male abbatoir worker presented to his general practitioner with acute hypoxemia due to bronchopneumonia. His only occupational exposure was cleaning cow carcasses being prepared for consumption. Blood cultures were eventually positive for Pasteurella multocida. To our knowledge, this is the first reported case of Pasteurella multocida pneumonia in an abattoir worker, and illustrates the importance of considering this infection in patients with animal exposures.

Obesity in asthma: approaches to treatment.

There is mounting evidence that obesity is associated with asthma, both of which are seeing a dramatic increase in prevalence. Not only is obesity a risk factor for the development of asthma but it is also associated with poor asthma control. Asthma phenotypes associated with obesity include early-onset allergic asthma and late-onset non-allergic asthma. The pathogenesis of the linkage is complex; obesity causes a variety of mechanical, metabolic, and immunological changes that can affect the airways. The treatment of asthma in obesity can be challenging, as obesity is associated with poor response to standard controller medications. A tailored approach that involves combining pharmacologic and non-pharmacologic therapies including weight loss, dietary interventions, and exercise, along with identification and treatment of obstructive sleep apnea, should therefore be considered in this population.