Kistik Fibrozisli Çocuklarda Oral Glikoz Tolerans Testi Değerlendirmesi

Öz

Amaç: Bu çalışmanın amacı, oral glikoz tolerans testi (OGTT) ile çeşitli yaş gruplarındaki kistik fibroz (KF) hastası çocuklarda kistik fibrozis ilişkili diyabet (KFİD) ve anormal glikoz toleransı (AGT) durumlarının varlığını ve sıklığını tespit etmek, beslenme durumu ile ilişkisini değerlendirmektir.
Materyal ve metod: Kistik fibroz tanısı konmuş 25 hastaya klinik olarak stabil dönemde iken standart 2 saatlik OGTT yapıldı. Plazma glikoz ve insülin düzeyleri ölçüldü. Hastalar normal glikoz toleransı (NGT), indetermine glikoz toleransı (İNGT), bozulmuş glikoz toleransı (BGT), KFİD veya bozulmuş açlık glikozu (BAG) olarak sınıflandırıldı. Normal glikoz toleransı, dışındaki tüm sınıflandırmalar AGT olarak kategorize edildi. Klinik ve antropometrik veriler kaydedildi ve tüm istatistiksel analizler SPSS 23 kullanılarak gerçekleştirildi.
Bulgular: Bu çalışmada, deneklerin %60'ı kadındı. OGTT'nin uygulandığı ortalama kronolojik yaş 9.44 ± 5.36 yıldı (min. 1.2 yıl). Hiçbir hastada açlık hiperglisemisi görülmedi. Hastaların 12'sinde (%48) NGT, 13'ünde (%52) AGT saptandı. Çalışmaya katılan 25 KF hastasından 5’ine (%20) KFİD tanısı konuldu; bunların 2’si (%8) tanı anında 10 yaşından küçüktü. AGT'li hastaların ortalama vücut ağırlığı standart sapması (SD) ve vücut kitle indeksi SD'si, NGT'li hastalara göre daha düşüktü.
Sonuç: Çalışma, KF’de KFİD ve AGT olasılığının göz önünde bulundurulmasını ve beş yaşından itibaren OGTT ile tarama yapılmasının gerekli olabileceğini göstermektedir. Kilo kaybı ve kilo alamama, KFİD ve AGT’nin erken belirtileri olabilir.

Anahtar Kelimeler

• Anormal glikoz toleransı
• Kistik fibrozis
• Kistik fibrozis ile ilişkili diyabet
• Oral glikoz tolerans testi

Etik Beyan

Ethical approval was obtained from the Clinical Research Ethics Committee of University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital (approval no: 2011-KAEK-25 2021/11-15, date: November 3).

Assessing Oral Glucose Tolerance Test in Children with Cystic Fibrosis

Öz

Background:  The objective of this study is to determine the presence and frequency of cystic fibrosis- related diabetes (CFRD) and abnormal glucose tolerance (AGT) in children with cystic fibrosis (CF) across various age groups using an oral glucose tolerance test (OGTT), and to evaluate their association with nutritional status.
Materials and Methods: Twenty-five patients diagnosed with CF underwent a standard 2-hour OGTT while in a clinically stable period. Plasma glucose and insulin levels were measured. Patients were categorised as normal glucose tolerance (NGT), indeterminate glucose tolerance (INDET), impaired glucose tolerance (IGT), CFRD or impaired fasting glucose (IFG). All classifications other than NGT were categorized as AGT. Clinical and anthropometric data was recorded, and all statistical analyses performed using SPSS 23.
Results: In the present study, 60% of the subjects were female. The mean chronological age at which the OGTT was performed was 9.44 ± 5.36 years (min 1.2 years). None of the patients had fasting hyperglycaemia. NGT was detected in 12 patients (48%), and AGT in 13 patients (52%). Of the 25 CF patients, 5 (20%) were diagnosed with CFRD, 2 (8%) of whom were less than 10 years old at the time of their diagnosis. The patients with AGT had a lower mean body weight standard deviation (SD) and body mass index SD than those with NGT. 
Conclusions: The findings of this study suggest that the possibility of CFRD and AGT should be considered in the context of CF, and that screening with an OGTT may be necessary starting at age five. Weight loss and failure to gain weight may be early signs of CFRD and AGT.

Anahtar Kelimeler

• Abnormal glucose tolerance
• Cystic fibrosis
• Cystic fibrosis-related diabetes
• Oral glucose tolerance test

Etik Beyan

Ethical approval was obtained from the Clinical Research Ethics Committee of University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital (approval no: 2011-KAEK-25 2021/11-15, date: November 3).

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