Despite translational evidences suggesting that cystic fibrosis-related abnormal glucose
tolerance (CF-related AGT) may begin early in life and is known to be associated with
increased morbidity and mortality, current guidelines recommend screening for AGT
only from 10 years of age, thus missing the opportunity for early detection and intervention.A
systematic review and meta-analysis (PROSPERO number: CRD42021282516) was conducted
on studies that reported data on the prevalence of AGT or its subtypes in CF populations.
Pooled proportions, risk, and odds ratios with 95 % confidence intervals (CI) were
calculated. One-stage dose-response random-effect meta-analysis was used to assess
the effect of age on CF-related diabetes (CFRD).The quantitative analysis included
457 studies and data from 520,544 patients. Every third child with CF (chwCF) (0.31
[95 % CI 0.25-0.37]) and every second adult with CF (awCF) (0.51 [95 % CI 0.45-0.57])
were affected by AGT. Even in the 5-10 years of age subgroup, the proportion of AGT
was 0.42 [95 % CI 0.34-0.51]. The prevalence of prediabetes remained unchanged (impaired
glucose tolerance in chwCF:0.14 [95 % CI 0.10-0.18]) vs. awCF:0.19 [95 % CI 0.14-0.25]),
whereas the proportion of CFRD increased with age (0-5: 0.005 [95 % CI 0.0001-0.15];
5-10: 0.05 [95 % CI 0.01-0.27]; 10-18: 0.11 [95 % CI 0.08-0.14]; >18 years of age:
0.27 [95 % CI 0.24-0.30]).CF-related AGT is common under 10 years of age. Our study
suggests considering earlier AGT screening, starting from 5 years of age. This highlights
the imperative for additional research for guideline adjustments and provides the
opportunity for early intervention.
