Introduction: Hydrocarbon Alteration (HA) is considered as the most common complication in Cystic Fibrosis (CF) and is related to a further deterioration of the lung function and the nutritional status.
Objective: Analyze the prevalence of HA in patients with CF in an adult unit and its relationship with pulmonary complications.
Material and methods: We conducted a retrospective study with 71 patients of our CF unit (age 30+/−9 years, 50.5% women, BMI 22.2+/−3.8 kg/m2 and CF evolution 22+/−9 years). Patients were classified, according to the glycaemic response to oral glucose overload, in 3 categories: normal glucose tolerance (NGT, 31%), pre-diabetes (preDM, 29.6%) and diabetes (CFRD, 39.4%). The analysis included the variables: age, sex, BMI, lung function, chronic bronchial infection, pulmonary exacerbations and its degree of severity. 32.4% of the patients received some hypoglycaemic treatment (78.6% of them were CFDR): 32% were under bolo-basal insulin, 28% basal insulin, 16% oral drugs and 24% other treatments. Statistical analysis was performed with STATAv12.0.
Results: Lower BMI was observed when comparing patients with CFRD (20.65+/−0.6 kg/m2) and preDM (23.72+/−0.7 kg/m2) (P=0.005); and a tendency was noticed between CFRD and NTG (22.64+/−0.6 kg/m2) (P=0.1). CFRD patients showed greater frequency of severe pulmonary exacerbations than preDM (P=0.016). Higher colonization prevalence by Staphylococcus aureus meticilin-resistant (MRSA) (NTG 4.54%, preDM 9.5%, CRFQ 17.86%) and Achromobacter xylosoxidans (NTG 4.54%, 19.05% preDM, DRFQ 21.43%) was observed. This trend was not noticed for Staphylococcus multisensible aureus, Pseudomonas aeruginosa, and Haemophilus influenzae.
Conclusions: HA is frequent among our CF patients. Lower BMI is associated with higher degree of HA. CFRD patients show more frequent severe pulmonary exacerbations and higher prevalence of infections by MRSA and Achromobacter xylosoxidans. This reinforces the importance of adequate nutritional and endocrine control as well as the need to a multidisciplinary approach for the treatment of CF patients.
20 - 23 May 2017
European Society of Endocrinology