Nasal Mucus Glucose and Chronic Rhinosinusitis

Abstract

Objectives:

Respiratory secretion glucose concentration is tightly regulated and contributes to airway innate immunity. Thus, we set out to quantify nasal mucus glucose concentration in chronic rhinosinusitis (CRS) patients and correlate these values to CRS symptoms.

Methods:

Prospective, single-center study measuring nasal mucus glucose concentration in patients diagnosed with chronic rhinosinusitis and age/race matched controls from July 1, 2013, to January 1, 2014. Enrollment included subjects >18 years of age evaluated in academic otolaryngology practice. Subjects completed questionnaires including extensive history of medical and surgical therapies as well as CRS-specific quality of life measurements (SNOT-22). Subjects underwent nasal secretion sampling with sterilized Pope ear wicks. The nasal glucose concentrations of controls and subjects were analyzed with multivariate analysis to assess for confounding variables including systemic and topical glucocorticoid treatment.

Results:

Ninety-five patients enrolled, and 3 patients were excluded because of history of sinonasal radiation. A statistically significant difference was measured between mean nasal glucose secretions of control subjects, 11.1 mg/dL (±1.0 mg/dL), compared to patients diagnosed with CRS, 18.4 mg/dL (±1.6 mg/dL) (P < .01). No significant correlation was evident comparing nasal glucose concentrations to SNOT-22 nor use of glucocorticoid (topical or systemic) therapy.

Conclusions:

CRS patients demonstrate elevated nasal glucose concentrations independent of therapeutic glucocorticoid use. However, nasal mucus glucose concentrations do not appear to correlate to CRS symptoms. The role of nasal mucus glucose concentrations in CRS pathophysiology has yet to be determined.