Abstract
Background
Life expectancy of the CF-patient has increased over the past two decades. As a consequence, more patients develop cystic-fibrosis related diabetes (CFRD). Previous studies showed that CFRD is associated with a stronger decline in pulmonary function.
Aims
The aim of this retrospective study was to examine whether in current times CFRD-patients have more infections and a stronger decline in both pulmonary function and Body Mass Index than non-diabetic CF-patients (NDCF).
Research design and methods
A population of 138 CF-patients aged 17–46 years from the UMCUtrecht Cystic Fibrosis Center was studied. Pulmonary function is measured on a three-monthly basis. All data on pulmonary function were reviewed in the period 1991–2011 using a mixed model analysis. BMI and infection frequency were reviewed in the period 2009–2011.
Results
The FEV1 at baseline was 57% of predicted in CFRD-patients compared to 74% in NDCF-patients (p<0.001). Both colonisation with Pseudomonas Aeruginosa and having CFRD were independently associated with a lower FEV1 at baseline (p=0.025 and p=0.036 respectively). The decline in FEV1 was similar in CFRD-patients and NDCF-patients (0.07 liters/year). There was no decline in BMI in either group. CFRD-patients had more infections requiring i.v. antibiotics than CF-controls, most notably in the group of patients with a FEV1< 45% of predicted (p=0.034).
Conclusions
Pulmonary function at baseline was worse in CFRD-patients than in non-CFRD patients. The decline in FEV1 in CFRD-patients was comparable to NDCF-patients. CFRD-patients with FEV1< 45% had the highest number of infections, possibly predisposing to pleural adhesions and more complicated lung transplantation.
- © 2012 ERS