A glycosylated hemoglobin A1c above 6% (42 mmol/mol) is associated with a high risk of developing Cystic Fibrosis-Related Diabetes and a lower probability of weight gain in both adults and children with Cystic Fibrosis
Authors' conclusion
An A1C above 6% may be associated with a high risk of developing CFRD and a lower probability of weight gain in both adults and children with CF.
Study context
- Population
- Children and adults with CF without diabetes at baseline, undergoing regular assessments including Oral Glucose Tolerance Test (OGTT)2 cohorts
- Participants
- 223 vs 289
- Exposure
- Baseline HbA1c categories for risk of cystic fibrosis-related diabetes (CFRD) and changes in body mass index (BMI) and forced expiratory volume (FEV1)
- Childrenn = 223
- Adultsn = 289
- Outcome
- CF-specific HbA1c thresholds associated with risk of progression to CFRD and with changes in BMI and FEV1
Methodological detailscross-sectional and longitudinal analyses, 2 cohorts (children and adults)
- Cross-sectional and longitudinal analyses
- 2 cohorts (children and adults)
Main finding
As reported in the abstract
Optimal HbA1c threshold for onset of OGTT-defined CFRD
| Group | Value | Sensitivity | Specificity |
|---|---|---|---|
| Adults | 5.9% | 67% | 71% |
| Children | 5.7% | 60% | 47% |
Value
Adults5.9%
Children5.7%
Sensitivity
Adults67%
Children60%
Specificity
Adults71%
Children47%
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| BMI change over time by baseline HbA1c, adults (linear mixed-effect model)HbA1c ≥ 6.0% vs HbA1c < 6% | P = 0.05 |
- BMI change over time by baseline HbA1c, adults (linear mixed-effect model): BMI increased with HbA1c < 6%; significantly less weight gain with HbA1c ≥ 6.0%
Progression to CFRD by baseline HbA1c (Kaplan-Meier)
- Increased risk of CFRD for HbA1c ≥ 6.0% in adults
- P = 0.002
- Increased risk of CFRD for HbA1c ≥ 5.5% in children
- P = 0.012
FEV1 by baseline HbA1c category, adults
- No difference in FEV1 according to baseline HbA1c category
Original publication
A glycosylated hemoglobin A1c above 6% (42 mmol/mol) is associated with a high risk of developing Cystic Fibrosis-Related Diabetes and a lower probability of weight gain in both adults and children with Cystic Fibrosis. Diabetes Metab. Published 2 June 2023. doi:10.
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