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Canadian Respiratory Journal
Volume 15, Issue 6, Pages 291-294
Original Article

Sex Disparities in Effects of Cystic Fibrosis-Related Diabetes on Clinical Outcomes: A Matched Study

Robert J Miller,1 Hugh D Tildesley,2 Pearce G Wilcox,3 Hongbin Zhang,4 and Stuart H Kreisman5

1Diabetes Research, St Paul’s Hospital, Canada
2Division of Endocrinology, St Paul’s Hospital, Canada
3Cystic Fibrosis Clinic, St Paul’s Hospital, Canada
4Department of Statistics, University of British Columbia, Canada
5Division of Endocrinology, St Paul’s Hospital, Vancouver, British Columbia, Canada

Copyright © 2008 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Cystic fibrosis-related diabetes (CFRD) is an increasingly prevalent comorbidity factor for patients with cystic fibrosis (CF). CFRD has been associated with an accelerated decline in clinical parameters and an increased mortality rate.

OBJECTIVES: To investigate the clinical impact of CFRD on pulmonary function and clinical status using a matched study design to further explore potential causality.

METHODS: Charts from the adult CF clinic at St Paul’s Hospital (Vancouver, British Columbia) were retrospectively reviewed. Forty CFRD patients with and without fasting hyperglycemia were matched to CF patients with nondiabetic glucose tolerance based on sex, age and forced expiratory volume in 1 s (FEV1).

RESULTS: Sixteen of 40 CFRD patients (40%) died compared with nine of 40 patient controls (23%) (P=0.13). CFRD patients were more likely to experience declines in FEV1 (P<0.01), especially women (P<0.01). Patients with CFRD were not more likely to be hospitalized (P=0.39). Body mass index did not differ between groups.

CONCLUSIONS: Patients with CFRD had higher rates of FEV1 deterioration than nondiabetic patients with CF, and showed a trend toward increased mortality. The present study suggests that CFRD has a significant clinical impact and should be carefully considered when evaluating the status of CF patients.