{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T09:38:37Z","timestamp":1763545117266,"version":"3.45.0"},"reference-count":28,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Cystic fibrosis-related diabetes (CFRD) is a frequent comorbidity in individuals with cystic fibrosis (CF). While insulin secretion defects are the primary mechanism in CFRD pathophysiology, insulin resistance may contribute as an additional risk factor. Early detection of insulin resistance may help identify patients at higher risk for earlier CFRD development. Objective: The aim of this study was to evaluate the ability of the Matsuda Index to identify insulin resistance in pediatric CF patients and to compare it with HOMA-IR as complementary indicators of glucose metabolism. Methods: In this cross-sectional study, fifty children with CF aged 6\u201316 years were included. The study involved measuring anthropometric data, fasting insulin, fasting glucose levels, glycated hemoglobin (HbA1c), and C-peptide. An assessment of glucose and insulin levels was performed on the patients through an oral glucose tolerance test (OGTT) at 0, 60, and 120 min. The Matsuda Index was computed, wherein a threshold of \u22644.5 signifies the presence of insulin resistance. Statistical analyses were conducted to compare insulin resistance and sensitivity across groups, using t-tests, correlation, and ANOVA. Results: Among the 50 observed patients, the average Matsuda index score was 17.08 with a standard deviation of 11.16. Eleven individuals (22%) exhibited insulin resistance with a Matsuda Index \u2264 4.5. These patients showed significantly higher insulin levels at 60 and 120 min during the OGTT, with statistically significant p-values of 0.008 and 0.002, respectively. Conclusions: The Matsuda Index may serve as a useful adjunctive tool to help identify insulin resistance in pediatric CF patients, particularly during puberty. Early detection of insulin resistance through the Matsuda Index may facilitate risk stratification and enable timely interventions that could potentially delay the onset or progression of CFRD. However, it should be noted that the \u22644.5 cut-off value was derived from adult studies, and its validity in pediatric CF populations has not been established, which represents a limitation of our finding.<\/jats:p>","DOI":"10.3390\/children12111566","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T09:58:42Z","timestamp":1763459922000},"page":"1566","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of Matsuda Index in Identifying Patients at Risk for Cystic Fibrosis-Related Diabetes Development"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3368-6451","authenticated-orcid":false,"given":"Serpil","family":"Albayrak","sequence":"first","affiliation":[{"name":"Department of Pediatric Endocrinology, Gaziantep Cengiz G\u00f6k\u00e7ek Maternity and Children\u2019s Hospital, 27010 Gaziantep, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7319-8535","authenticated-orcid":false,"given":"Elif","family":"Ar\u0131k","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3061-7832","authenticated-orcid":false,"given":"\u00d6zlem","family":"Keskin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murat","family":"Karao\u011flan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Keskin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaye","family":"\u0130nal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9260-7587","authenticated-orcid":false,"given":"Mahmut","family":"Cesur","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1824-2038","authenticated-orcid":false,"given":"Ercan","family":"K\u00fc\u00e7\u00fckosmano\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmet","family":"Y\u0131ld\u0131r\u0131m","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"ref_1","first-page":"100290","article-title":"Cystic Fibrosis-related Diabetes: Prevalence, Screening, and Diagnosis","volume":"27","author":"Khare","year":"2022","journal-title":"J. Clin. Transl. Endocrinol."},{"key":"ref_2","first-page":"102899","article-title":"Advances in Cystic fibrosis-related diabetes: Current Status and Future Directions","volume":"17","author":"Lurquin","year":"2023","journal-title":"Syndr. Clin. Res. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Anton-P\u0103duraru, D.A.-O.X., Murgu, A.M., Donos, M.A., Trofin, F., Azoic\u0103i, A.N., Popovici, P., Stana, A.B., Gheorghiescu, I., and Trandafir, L.M. (2023). An Update in Cystic Fibrosis-Related Diabetes in Children and Adolescents. Children, 10.","DOI":"10.3390\/children10121879"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1164\/rccm.201512-2518OC","article-title":"Abnormal Glucose Tolerance in Infants and Young Children with Cystic Fibrosis","volume":"194","author":"Yi","year":"2016","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"108233","DOI":"10.1016\/j.diabres.2020.108233","article-title":"Review of Methods for Detecting Glycemic Disorders","volume":"165","author":"Bergman","year":"2020","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2188","DOI":"10.1007\/s00125-024-06220-6","article-title":"Insulin sensitivity, Disposition Index and Insulin Clearance in Cystic fibrosis: A cross-sectional Study","volume":"67","author":"Nielsen","year":"2024","journal-title":"Diabetologia"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e500","DOI":"10.1542\/peds.2004-1921","article-title":"Homeostasis model assessment is more reliable than the fasting glucose\/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents","volume":"115","author":"Keskin","year":"2005","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Khalili, D., Marjan, K., Karim, K., Ahanchi, N.S., Hasheminia, M., Hadaegh, F., Tohidi, M., Azizi, F., and Habibi-Moeini, A.S. (2023). Are HOMA-IR and HOMA-B Good Predictors for Diabetes and pre-diabetes subtypes?. BMC Endocr. Disord., 23.","DOI":"10.1186\/s12902-023-01291-9"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/pedi.12146","article-title":"Estimation of insulin sensitivity in children: Methods, measures and controversies","volume":"15","author":"Brown","year":"2014","journal-title":"Pediatr. Diabetes"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1007\/s00125-023-06034-y","article-title":"HOMA-IR and the Matsuda Index as predictors of progression to type 1 diabetes in autoantibody-positive relatives","volume":"67","author":"Petrelli","year":"2023","journal-title":"Diabetologia"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Malag\u00f3n-Soriano, V.A., Ledezma-Forero, A.J., Espinel-Pachon, C.F., Burgos-C\u00e1rdenas, \u00c1.J., Garces, M.F., Ortega-Ram\u00edrez, G.E., Franco-Vega, R., Peralta-Franco, J.J., Maldonado-Acosta, L.M., and Rubio-Romero, J.A. (2024). Surrogate indices of insulin resistance using the Matsuda index as reference in adult men-a computational approach. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1343641"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Piona, C., Mozzillo, E., Tosco, A., Volpi, S., Rosanio, F.M., Cimbalo, C., Franzese, A., Raia, V., Zusi, C., and Emiliani, F. (2022). Impact of CFTR Modulators on Beta-Cell Function in Children and Young Adults with Cystic Fibrosis. J. Clin. Med., 11.","DOI":"10.3390\/jcm11144149"},{"key":"ref_13","first-page":"117955142110382","article-title":"Associations between Glucose Tolerance, Insulin Secretion, Muscle and Fat Mass in Cystic Fibrosis","volume":"14","author":"Nielsen","year":"2021","journal-title":"Diabetes"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1111\/pedi.13453","article-title":"ISPAD Clinical Practice Consensus Guidelines 2022: Management of cystic fibrosis-related diabetes in children and adolescents","volume":"23","author":"Ode","year":"2022","journal-title":"Pediatr. Diabetes"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1002\/ppul.21495","article-title":"Cystic Fibrosis Related Diabetes (CFRD)\u2014The End Stage of Progressive Insulin Deficiency","volume":"46","author":"Hameed","year":"2011","journal-title":"Pediatr. Pulmonol."},{"key":"ref_16","first-page":"e45428","article-title":"Effects of Type 1 Diabetes Mellitus on Linear Growth: A Comprehensive Review","volume":"15","author":"Jadhav","year":"2023","journal-title":"Cureus"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1210\/clinem\/dgac020","article-title":"New Concepts in the Pathogenesis of Cystic Fibrosis\u2013Related Diabetes","volume":"107","author":"Moheet","year":"2022","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1159\/000500436","article-title":"Prevalence of Severe Obesity among Primary School Children in 21 European Countries","volume":"12","author":"Spinelli","year":"2019","journal-title":"Obes. Facts"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1007\/s12020-022-03276-5","article-title":"Central and Peripheral Sensitivity to Thyroid Hormones and Glucose Metabolism in Prepubertal Children with obesity: Pilot Multicenter Evaluation","volume":"80","author":"Corica","year":"2022","journal-title":"Endocrine"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Stanka, L., Velimir, A., Andrea Vuki\u0107, D., and Maja, B. (2024). The Role of Continuous Glucose Monitoring in Detecting Early Dysglycemia and Clinical Outcomes in Patients with Cystic Fibrosis. Medicina, 60.","DOI":"10.3390\/medicina60030477"},{"key":"ref_21","first-page":"19","article-title":"Cystic Fibrosis Related Diabetes: A First Canadian Clinical Practice Guideline","volume":"49","year":"2024","journal-title":"Can. J. Diabetes"},{"key":"ref_22","first-page":"616","article-title":"Early Onset of Abnormal Glucose Tolerance in Patients with Cystic fibrosis: A Systematic Review and meta-analysis","volume":"4","author":"Dorina","year":"2024","journal-title":"J. Cyst. Fibros."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Cerf, M.E. (2013). Beta Cell Dysfunction and Insulin Resistance. Front. Endocrinol., 4.","DOI":"10.3389\/fendo.2013.00037"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1152\/physrev.00008.2017","article-title":"Pancreatic \u03b2-Cell Electrical Activity and Insulin Secretion: Of Mice and Men","volume":"98","author":"Rorsman","year":"2018","journal-title":"Physiol. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.jcjd.2018.04.008","article-title":"Cystic Fibrosis-Related Diabetes Screening in Adults: A Gap Analysis and Evaluation of Accuracy of Glycated Hemoglobin Levels","volume":"43","author":"Gilmour","year":"2019","journal-title":"Can. J. Diabetes"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jcf.2023.11.005","article-title":"Decline in HbA1c During the First Year of Elexacaftor\/Tezacaftor\/Ivacaftor Treatment in the Danish Cystic Fibrosis Cohort","volume":"23","author":"Hee","year":"2024","journal-title":"J. Cyst. Fibros."},{"key":"ref_27","unstructured":"Muniyappa, R., and Madan, R. (2021). Assessing Insulin Sensitivity and Resistance in Humans, MDText.com, Inc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100","DOI":"10.4274\/jcrpe.v2i3.100","article-title":"Insulin Resistance in Obese Children and Adolescents: HOMA-IR Cut-Off Levels in the Prepubertal and Pubertal Periods","volume":"2","author":"Kurtoglu","year":"2024","journal-title":"J. Clin. Res. Pediatr. Endocrinol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/11\/1566\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T09:26:18Z","timestamp":1763544378000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/11\/1566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":28,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["children12111566"],"URL":"https:\/\/doi.org\/10.3390\/children12111566","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2025,11,18]]}}}