Pediatr Diabetes. 2010 Feb 8.
Low prevalence of glucose intolerance in racially mixed children with cystic fibrosis.
Federal University of Bahia, Salvador-Bahia, Brazil.
Alves C, Lima DS, Cardeal M, Santana A.
Objective: To evaluate glucose tolerance in racially mixed Brazilian youth with cystic fibrosis (CF).
Methods: Cross-sectional study conducted between August and September 2007, at a reference service for CF, evaluating: glycated hemoglobin (HbA1c), blood glucose, and insulin levels, before and 2 h after a glucose overload.
Results: There were 46 patients aged between 6 yr and 16 yr and 2 months (median: 9 yr and 10 months) of whom 64% were boys. Of these, 26% were Whites; 54.4% Mulattoes; and 19.6% Blacks. HbA1c was normal in all patients. Only one participant (12-yr old) had glucose intolerance. Insulin levels ranged from 1 to 23 microIU/mL (median: 4.5 microIU/mL) at baseline and from 3.2 to 192.1 microIU/mL (median: 11 microIU/mL) after a glucose overload. Insulin resistance evaluated by the HOMA index, stratified by sex and age, was present in three patients. The DeltaF508 mutation was present in only 4.3% of the sample, all of them being heterozygous.
Conclusions: The low prevalence of carbohydrate intolerance in this population is probably a result of their young age. Another possibility is the low frequency of the DeltaF508 mutation. Although not conclusive, these data suggest that in addition to age, the genotype:phenotype ratio may influence the development of glucose intolerance in patients with CF.