システィック線維症の新興成人における移行期における内分泌のケア:単一センターの遡及研究
Crystal Cobb1, Jenna Feeley2, José Nilo G Binongo3
1Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
まとめ
システィック線維症関連糖尿病 (CFRD) や骨疾患 (CFBD) のような内分泌合併症は,成人システィック線維症 (CF) 治療に移行する新興成人において悪化します. この脆弱な時期におけるスクリーニングの強化は極めて重要です.
科学分野:
- エンドクリノロジー エンドクリノロジー
- 肺病理学 肺病理学とは
- 小児科は小児科です.
背景:
- システィック線維症 (CF) は,通常,システィック線維症に関連する糖尿病 (CFRD) とシスティック線維症に関連する骨疾患 (CFBD) を含む内分泌の問題を提示します.
- 小児から成人のケアへの移行は,CF内分泌病の管理にとって重要な時期ですが,この段階の傾向は十分に研究されていません.
研究 の 目的:
- 成人ケアへの移行から最大10年後のCFの新興成人における血糖制御 (CFRD) と骨密度 (CFBD) の変化を調査する.
- この移行期間の内分泌のスクリーニング率を分析する.
主な方法:
- 成人のCFケアに移行している94人の参加者 (18〜30歳) の遡及的チャートレビュー.
- 骨のミネラル密度 (BMD) とビタミンD状態の比較.
- 線形混合効果モデルを使用して,時間経過におけるヘモグロビンA1c (HbA1c) の動向の分析.
主要な成果:
- インスリンでCFRDを患った参加者は,成人ケアから5年以内にHbA1c (7.8%から9.4%) の有意な増加を示した (p=0.003).
- 47%の新興成人では少なくとも1つの低BMDZスコア (<-1) がありました.
- 経口グルコース耐性テスト (OGTT) とDXAスクリーニングの完了率は低いことが観察されました.
結論:
- CFRDとCFBDの健康結果は,CF患者の小児から成人のケアへの移行中に悪化します.
- 医療提供者は,この脆弱な移行段階を認識し,CFRDとCFBDの強化されたスクリーニングプログラムを導入する必要があります.
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