Dyslipidemia is not associated with the development of glucose intolerance or diabetes in cystic fibrosis

Background: A high-fat, high-calorie diet is recommended in patients with cystic fibrosis (CF) as it improves nutritional status, respiratory health and longevity. In the general population, this diet is associated with the risk of diabetes. It is unknown whether dyslipidemic changes might contribute to the development of CF-related diabetes (CFRD). Objective: This study aimed to (i) characterize dyslipidemia and (ii) examine the association between dyslipidemia and development of glucose intolerance. Methods: Prospective observational study with serial assessments of pulmonary function, glucose tolerance, and lipid profile. Due to intrinsically low total, HDL and LDL cholesterol in patients with CF, subjects were characterized as having dyslipidemia if they had i) HDL in the lowest quartile and/or ii) hypertriglyceridemia (>= 1.7 mmol/L). Results: A total of 256 patients with CF were included (age: 25.5 +/- 7.7 years; BMI: 21.7 +/- 3.0 kg/m2; FEV1%: 73.2 +/- 22.1%; pancreatic insufficiency: 87%). Amongst these patients, 22.7% had low HDL, 9.0% had hypertriglyceridemia and 3.9% had mixed dyslipidemia. There were no differences in HbA1c (p =0.583) or estimated insulin resistance [HOMA-IR (p=0.206) or Stumvoll index (p=0.397)]. Patients with hypertriglyceridemia had higher fat mass (p =0.038) and fewer had pancreatic insufficiency. Lipid profiles were similar between subjects with CF and subjects with de novo CFRD. There was no effect of low HDL or hypertriglyceridemia on the development of CFRD over 10 years (p =0.683). Conclusion: In adult patients with CF, dyslipidemia is not associated with the risk of developing hyperglycemia or CFRD. (C) 2020 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.