PURPOSE:New therapies have led to improved survival in patients with cystic fibrosis (CF), leading to increasing exposure of these patients to cardiovascular risk factors. Diabetes, which is associated with abnormal lipid profile, is a common co-morbidity in CF. Therefore, early detection of metabolic abnormalities might be an important component of preventive strategies in patients with CF.
METHODS:Data on 179 patients (>18yrs old) were retrospectively collected. Levels of random serum glucose, total-cholesterol, LDL-cholesterol, HDL-cholesterol, glucosylated hemoglobin (HbA1c), and disease severity were recorded. The reported US population values by the National Health Examination Survey (NHES) and the National Health and Nutrition Examination Surveys (NHANES) were used as historical control group to compare with values of CF patients by age group.
RESULTS:Patients had median age 28 years (IQR 21–35 years), 55% were men, and median predicted %FEV1 was 70% (IQR 48%–89%). Of these, 59 (33.0%) were diagnosed with CF-related diabetes mellitus and 46 (25.7%) were on insulin therapy; 75 additional patients (41.9%) had been diagnosed with glucose intolerance. Serum lipid concentrations for the total cohort and by age groups are presented in the Table. Total cholesterol was significantly lower than historical controls across all age groups. However, patients aged 30–39 years had increased serum triglyceride concentrations compared to their control counterparts. Levels of HbA1c were higher in CF patients compared to historical controls, 6.4±0.1 mg/dl vs. 5.3±0.5 mg/dl, p<0.03.
CONCLUSION:Patients with CF appear to have an increased burden of diabetes mellitus and glucose intolerance, which is accompanied by hypertriglyceridemia, especially in the age group 30–39 years. Further prospective studies are needed to confirm the prevalence of these risk factors and to quantify the effect on incident cardiovascular disease in these patients.
CLINICAL IMPLICATIONS:Identification of possible cardiovascular risk factors in patients with CF will lead to effective preventive strategies in these patients.
DISCLOSURE:Vasiliki Georgiopoulou, None.