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Associations Between Glucose Tolerance, Insulin Secretion, Muscle and Fat Mass in Cystic Fibrosis

BACKGROUND: A frequent comorbidity in cystic fibrosis (CF) is CF related diabetes (CFRD) caused by a gradual decline in insulin secretion. The reduction in the anabolic hormone, insulin, might explain the weight loss that precedes onset of CFRD. We investigated the association between muscle and fat...

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Autores principales: Nielsen, Bibi Uhre, Faurholt-Jepsen, Daniel, Oturai, Peter Sandor, Qvist, Tavs, Krogh-Madsen, Rikke, Katzenstein, Terese Lea, Shaw, James, Ritz, Christian, Pressler, Tacjana, Almdal, Thomas Peter, Mathiesen, Inger Hee Mabuza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369959/
https://www.ncbi.nlm.nih.gov/pubmed/34413690
http://dx.doi.org/10.1177/11795514211038259
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author Nielsen, Bibi Uhre
Faurholt-Jepsen, Daniel
Oturai, Peter Sandor
Qvist, Tavs
Krogh-Madsen, Rikke
Katzenstein, Terese Lea
Shaw, James
Ritz, Christian
Pressler, Tacjana
Almdal, Thomas Peter
Mathiesen, Inger Hee Mabuza
author_facet Nielsen, Bibi Uhre
Faurholt-Jepsen, Daniel
Oturai, Peter Sandor
Qvist, Tavs
Krogh-Madsen, Rikke
Katzenstein, Terese Lea
Shaw, James
Ritz, Christian
Pressler, Tacjana
Almdal, Thomas Peter
Mathiesen, Inger Hee Mabuza
author_sort Nielsen, Bibi Uhre
collection PubMed
description BACKGROUND: A frequent comorbidity in cystic fibrosis (CF) is CF related diabetes (CFRD) caused by a gradual decline in insulin secretion. The reduction in the anabolic hormone, insulin, might explain the weight loss that precedes onset of CFRD. We investigated the association between muscle and fat mass in relation to glucose tolerance and insulin function. METHODS: In a cross-sectional study with CF patients (⩾18 years), we conducted an oral glucose tolerance test and dual energy X-ray absorptiometry scan (DXA). Based on plasma glucose, glucose tolerance was defined as normal (NGT): 1-hour <11.1 mmol/L and 2-hour <7.8 mmol/L, impaired (IGT): 2-hour ⩾7.8 and <11.1 mmol/L or CFRD: 2-hour ⩾11.1 mmol/L. Insulin resistance (HOMA-IR) was derived from fasting levels of plasma glucose and plasma insulin, and fat-free and fat mass index (kg/m(2)) from DXA. Associations were evaluated using linear regression models adjusted for age, sex, and pancreas insufficiency. RESULTS: Among 79 CF patients with exocrine pancreas insufficiency, impairment of glucose tolerance corresponded to reduced insulin secretion. In the IGT group the fat-free mass index (FFMI) was 1.2 kg/m(2) (95% CI: [−2.3, −0.03] kg/m(2), P = .044) lower compared to the NGT group. FFMI increased insignificantly by 0.4 kg/m(2) (95% CI: [−0.6, 1.5] kg/m(2), P = .422) among the insulin-treated CFRD group compared to IGT. Fat mass index (FMI) was not different between groups but tended to decrease with glucose tolerance impairment. For each 100 pmol/L increase in fasting insulin FFMI increased by 1.77 kg/m(2) (95% CI: [0.21, 3.33] kg/m(2)/pmol/L/100) and FMI increased by 6.15 kg/m(2) (95% CI: [3.87, 8.44] kg/m(2)/pmol/L/100). In multivariate analyses, HOMA-IR was positively associated with FFMI (β = 0.5 kg/m(2)/HOMA-IR, 95% CI: [0.08, 0.92] kg/m(2)/HOMA-IR, P = .021) and FMI (β = 1.5 kg/m(2)/HOMA-IR, 95% CI: [0.87, 2.15] kg/m(2)/HOMA-IR, P < .001). CONCLUSIONS: Muscle mass was significantly lower among participants with impaired glucose tolerance (IGT), while muscle mass was normalized among those treated with insulin.
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spelling pubmed-83699592021-08-18 Associations Between Glucose Tolerance, Insulin Secretion, Muscle and Fat Mass in Cystic Fibrosis Nielsen, Bibi Uhre Faurholt-Jepsen, Daniel Oturai, Peter Sandor Qvist, Tavs Krogh-Madsen, Rikke Katzenstein, Terese Lea Shaw, James Ritz, Christian Pressler, Tacjana Almdal, Thomas Peter Mathiesen, Inger Hee Mabuza Clin Med Insights Endocrinol Diabetes Original Research BACKGROUND: A frequent comorbidity in cystic fibrosis (CF) is CF related diabetes (CFRD) caused by a gradual decline in insulin secretion. The reduction in the anabolic hormone, insulin, might explain the weight loss that precedes onset of CFRD. We investigated the association between muscle and fat mass in relation to glucose tolerance and insulin function. METHODS: In a cross-sectional study with CF patients (⩾18 years), we conducted an oral glucose tolerance test and dual energy X-ray absorptiometry scan (DXA). Based on plasma glucose, glucose tolerance was defined as normal (NGT): 1-hour <11.1 mmol/L and 2-hour <7.8 mmol/L, impaired (IGT): 2-hour ⩾7.8 and <11.1 mmol/L or CFRD: 2-hour ⩾11.1 mmol/L. Insulin resistance (HOMA-IR) was derived from fasting levels of plasma glucose and plasma insulin, and fat-free and fat mass index (kg/m(2)) from DXA. Associations were evaluated using linear regression models adjusted for age, sex, and pancreas insufficiency. RESULTS: Among 79 CF patients with exocrine pancreas insufficiency, impairment of glucose tolerance corresponded to reduced insulin secretion. In the IGT group the fat-free mass index (FFMI) was 1.2 kg/m(2) (95% CI: [−2.3, −0.03] kg/m(2), P = .044) lower compared to the NGT group. FFMI increased insignificantly by 0.4 kg/m(2) (95% CI: [−0.6, 1.5] kg/m(2), P = .422) among the insulin-treated CFRD group compared to IGT. Fat mass index (FMI) was not different between groups but tended to decrease with glucose tolerance impairment. For each 100 pmol/L increase in fasting insulin FFMI increased by 1.77 kg/m(2) (95% CI: [0.21, 3.33] kg/m(2)/pmol/L/100) and FMI increased by 6.15 kg/m(2) (95% CI: [3.87, 8.44] kg/m(2)/pmol/L/100). In multivariate analyses, HOMA-IR was positively associated with FFMI (β = 0.5 kg/m(2)/HOMA-IR, 95% CI: [0.08, 0.92] kg/m(2)/HOMA-IR, P = .021) and FMI (β = 1.5 kg/m(2)/HOMA-IR, 95% CI: [0.87, 2.15] kg/m(2)/HOMA-IR, P < .001). CONCLUSIONS: Muscle mass was significantly lower among participants with impaired glucose tolerance (IGT), while muscle mass was normalized among those treated with insulin. SAGE Publications 2021-08-13 /pmc/articles/PMC8369959/ /pubmed/34413690 http://dx.doi.org/10.1177/11795514211038259 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Nielsen, Bibi Uhre
Faurholt-Jepsen, Daniel
Oturai, Peter Sandor
Qvist, Tavs
Krogh-Madsen, Rikke
Katzenstein, Terese Lea
Shaw, James
Ritz, Christian
Pressler, Tacjana
Almdal, Thomas Peter
Mathiesen, Inger Hee Mabuza
Associations Between Glucose Tolerance, Insulin Secretion, Muscle and Fat Mass in Cystic Fibrosis
title Associations Between Glucose Tolerance, Insulin Secretion, Muscle and Fat Mass in Cystic Fibrosis
title_full Associations Between Glucose Tolerance, Insulin Secretion, Muscle and Fat Mass in Cystic Fibrosis
title_fullStr Associations Between Glucose Tolerance, Insulin Secretion, Muscle and Fat Mass in Cystic Fibrosis
title_full_unstemmed Associations Between Glucose Tolerance, Insulin Secretion, Muscle and Fat Mass in Cystic Fibrosis
title_short Associations Between Glucose Tolerance, Insulin Secretion, Muscle and Fat Mass in Cystic Fibrosis
title_sort associations between glucose tolerance, insulin secretion, muscle and fat mass in cystic fibrosis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369959/
https://www.ncbi.nlm.nih.gov/pubmed/34413690
http://dx.doi.org/10.1177/11795514211038259
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