详细记录  
题名:Insulin secretion improves in cystic fibrosis following ivacaftor correction of CFTR: a small pilot study.
作者:BELLIN MD; LAGUNA T; LESCHYSHYN J; REGELMANN W; DUNITZ J; BILLINGS J; MORAN A;
来源:Pediatr Diabetes. 2013 Sep;14(6):417-21. doi: 10.1111/pedi.12026. Epub 2013 Mar [ IF= 0.00 ] ]
URL :10.1111/pedi.12026
日期:20131002
摘要:OBJECTIVE: To determine whether the cystic fibrosis (CF) transmembrane
conductance regulator (CFTR) is involved in human insulin secretion by assessing
the metabolic impact of the new CFTR corrector-ivacaftor. METHODS: This
open-label pilot study was conducted in CF patients with the G551D mutation given
new prescriptions for ivacaftor. At baseline and 4 wk after daily ivacaftor
therapy, intravenous glucose tolerance tests (IVGTT) and oral glucose tolerance
tests (OGTT) were performed. RESULTS: Five patients aged 6-52 were studied. After
1 month on ivacaftor, the insulin response to oral glucose improved by 66-178% in
all subjects except one with long-standing diabetes. OGTT glucose levels were not
lower in the two individuals with diabetes or the two with normal glucose
tolerance (NGT), but the glucose tolerance category in the subject with impaired
glucose tolerance (IGT) improved to NGT after treatment. In response to
intravenous glucose, the only patient whose acute insulin secretion did not
improve had newly diagnosed, untreated CFRD. The others improved by 51-346%.
Acute insulin secretion was partially restored in two subjects with no measurable
acute insulin response at baseline, including the one with IGT and the one with
long-standing diabetes. CONCLUSIONS: This small pilot study suggests there is a
direct role of CFTR in human insulin secretion. Larger, long-term longitudinal
studies are necessary to determine whether early initiation of CFTR correction,
particularly in young children with CF who have not yet lost considerable
beta-cell mass, will delay or prevent development of diabetes in this high-risk
population.

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