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Izsák VD, Soós A, Szakács Z, Hegyi P, Juhász MF, Varannai O, Martonosi ÁR, Földi M, Kozma A, Vajda Z, Shaw JAM, Párniczky A. Screening Methods for Diagnosing Cystic Fibrosis-Related Diabetes: A Network Meta-Analysis of Diagnostic Accuracy Studies. Biomolecules 2021; 11:520. [PMID: 33807165 PMCID: PMC8065857 DOI: 10.3390/biom11040520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cystic fibrosis-related diabetes (CFRD) has become more common due to higher life expectancy with cystic fibrosis. Early recognition and prompt treatment of CFRD leads to improved outcomes. METHODS We performed a network meta-analysis (NMA) in order to identify the most valuable diagnostic metrics for diagnosing CFRD out of available screening tools (index test), using the oral glucose tolerance test as a reference standard. Pooled sensitivity (Se), specificity (Sp), and superiority indices were calculated and used to rank the index tests. RESULTS A total of 31 articles with 25 index tests were eligible for inclusion. Two-day, continuous glucose monitoring (CGM) ranked the highest (Se: 86% Sp: 76%), followed by glucose measurement from blood capillary samples (Se: 70%, Sp: 82%) and three-day CGM (Se: 96%, Sp: 56%). When we compared the CGM of different durations, two-day CGM performed best (Se: 88%, Sp: 80%), followed by three-day (Se: 96%, Sp: 59%) and six-day CGM (Se: 66%, Sp: 79%). CONCLUSIONS Considering its overall performance ranking, as well as the high sensitivity, two-day CGM appears to be a promising screening test for CFRD.
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Affiliation(s)
- Vera Dóra Izsák
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (V.D.I.); (A.S.); (Z.S.); (P.H.); (M.F.J.); (O.V.); (Á.R.M.); (M.F.); (A.K.)
- Heim Pál National Pediatrics Institute, 1089 Budapest, Hungary;
- Doctoral School of Clinical Medicine, University of Szeged, 6720 Szeged, Hungary
| | - Alexandra Soós
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (V.D.I.); (A.S.); (Z.S.); (P.H.); (M.F.J.); (O.V.); (Á.R.M.); (M.F.); (A.K.)
| | - Zsolt Szakács
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (V.D.I.); (A.S.); (Z.S.); (P.H.); (M.F.J.); (O.V.); (Á.R.M.); (M.F.); (A.K.)
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (V.D.I.); (A.S.); (Z.S.); (P.H.); (M.F.J.); (O.V.); (Á.R.M.); (M.F.); (A.K.)
- Doctoral School of Clinical Medicine, University of Szeged, 6720 Szeged, Hungary
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Márk Félix Juhász
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (V.D.I.); (A.S.); (Z.S.); (P.H.); (M.F.J.); (O.V.); (Á.R.M.); (M.F.); (A.K.)
| | - Orsolya Varannai
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (V.D.I.); (A.S.); (Z.S.); (P.H.); (M.F.J.); (O.V.); (Á.R.M.); (M.F.); (A.K.)
- Heim Pál National Pediatrics Institute, 1089 Budapest, Hungary;
- Doctoral School of Clinical Medicine, University of Szeged, 6720 Szeged, Hungary
| | - Ágnes Rita Martonosi
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (V.D.I.); (A.S.); (Z.S.); (P.H.); (M.F.J.); (O.V.); (Á.R.M.); (M.F.); (A.K.)
- Heim Pál National Pediatrics Institute, 1089 Budapest, Hungary;
- Doctoral School of Clinical Medicine, University of Szeged, 6720 Szeged, Hungary
| | - Mária Földi
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (V.D.I.); (A.S.); (Z.S.); (P.H.); (M.F.J.); (O.V.); (Á.R.M.); (M.F.); (A.K.)
- Doctoral School of Clinical Medicine, University of Szeged, 6720 Szeged, Hungary
| | - Alexandra Kozma
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (V.D.I.); (A.S.); (Z.S.); (P.H.); (M.F.J.); (O.V.); (Á.R.M.); (M.F.); (A.K.)
| | - Zsolt Vajda
- Heim Pál National Pediatrics Institute, 1089 Budapest, Hungary;
| | - James AM Shaw
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK;
| | - Andrea Párniczky
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (V.D.I.); (A.S.); (Z.S.); (P.H.); (M.F.J.); (O.V.); (Á.R.M.); (M.F.); (A.K.)
- Heim Pál National Pediatrics Institute, 1089 Budapest, Hungary;
- Doctoral School of Clinical Medicine, University of Szeged, 6720 Szeged, Hungary
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Alves C, Lima D, Cardeal M, Santana A. Dyslipidemia in racially admixtured children with cystic fibrosis. Indian J Endocrinol Metab 2012; 16:585-588. [PMID: 22837921 PMCID: PMC3401761 DOI: 10.4103/2230-8210.98016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES There are few studies reporting lipid profile in cystic fibrosis (CF) and most of them are in adult Caucasians. Therefore, the aim of this study was to evaluate the lipid profile of racially admixtured youths with CF. MATERIALS AND METHODS A cross-sectional survey conducted between August and September 2009 at a reference service for CF, evaluating clinical and laboratory data. RESULTS Forty-six patients aged from 6 years to 16 years and 2 months (median: 9 years and 10 months; 65.2% males) were evaluated. Of these, 26% were Whites, 54.4% Mulattoes and 19.6% Blacks. There were no diabetics, one patient had glucose intolerance and three had insulin resistance. Pancreatic sufficiency was present in 74% and malnutrition in 26% of the patients. The lipid profile revealed hypertriglyceridemia in 56%, hypercholesterolemia in 17.4% and hypocholesterolemia in 46.5%. In 30.4% of the patients, hypertriglyceridemia and hypocholesterolemia was observed. The serum levels of high density lipoprotein (HDL) were low in 56.5% and the low density lipoprotein (LDL) elevated in 15.2% of the patients. CONCLUSIONS The lipid profile of this sample of Brazilian racially admixtured patients with CF showed a higher prevalence of hypertriglyceridemia and hypocholesterolemia. There was no association of dyslipidemia with the various racial groups, nutritional status, pancreatic sufficiency or glucose tolerance.
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Affiliation(s)
- Cresio Alves
- Pediatric Endocrinology Unit, Hospital Universitario Prof. Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Daniela Lima
- Pediatric Endocrinology Unit, Hospital Universitario Prof. Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Mauricio Cardeal
- Pediatric Endocrinology Unit, Hospital Universitario Prof. Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Angelica Santana
- Cystic Fibrosis Referral Center, Hospital Octavio Mangabeira, Salvador, Brazil
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