Body composition and lung function in adults with Cystic Fibrosis

Aleksandra John; Joanna Goździk-Spychalska; Magdalena Durda-Masny; Wojciech Czaiński; Marta Gębala; Jolanta Wlizło; Halina Batura-Gabryel; Anita Szwed

doi:10.2478/anre-2020-0021

Authors

Aleksandra John Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 6, 61-614 Poznań, Poland
Joanna Goździk-Spychalska Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, Szamarzewskiego 82/84, 60-569 Poznań, Poland
Magdalena Durda-Masny Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 6, 61-614 Poznań, Poland
Wojciech Czaiński Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, Szamarzewskiego 82/84, 60-569 Poznań, Poland
Marta Gębala Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 6, 61-614 Poznań, Poland
Jolanta Wlizło Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, Szamarzewskiego 82/84, 60-569 Poznań, Poland
Halina Batura-Gabryel Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, Szamarzewskiego 82/84, 60-569 Poznań, Poland
Anita Szwed Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 6, 61-614 Poznań, Poland

DOI:

https://doi.org/10.2478/anre-2020-0021

Keywords:

cystic fibrosis, FEV1%, fat free mass, fat mass, nutritional status

Abstract

The study aimed to assess: (1) differences in nutritional status and lung function between CF patients and the control group; (2) differences in body composition and lung function between groups of patients with CF designated by type of mutation; (3) the relationship between lung function and body composition in CF patients.

We studied 37 CF patients aged 19 to 51 years, and 41 healthy non-CF volunteers. Nutritional status was evaluated based on the BMI and the bioelectrical impedance analysis. The lung function was described by FEV1%. CF patients were classified according to the CFTR genotype based on five classes of mutations.

BMI were lower in CF patients compared to reference group (women: Z = 3.76, p <0.001, men: Z = 3.06, p = 0.002). CF patients had a lower mean content of particular body components, as well as FEV1% values. BMI differed significantly depending on the type of mutation in females (H = 10.33, p = 0.006) and males (H = 8.26, p = 0.016). The lowest values of BMI were observed in the group of patients with severe types of mutations. Also, variables describing body composition were statistically significantly lower in patients with a severe type of mutations. The CFTR gene mutation type statistically significantly differentiated FEV1% (H = 23.22, p <0.000). The results of the logistic regression analysis showed that the likelihood of dropping FEV1% below the norm was twice as high in undernourished females and males.

To assess the nutritional status of CF patients, more informative methods describing the proportions of body components are required.

Downloads

Download data is not yet available.

References

Steinkamp G, Wiedemann B. 2002. Relationship between nutritional status and lung function in cystic fibrosis: cross sectional and longitudinal analyses from the German CF quality assurance (CFQA) project. Thorax 57:596–601.
View in Google Scholar

Sinaasappel M, Stern M, Littlewood J, Wolfe S, Steinkamp G, Heijerman HGM, Robberecht E, Doring G. 2002. Nutrition in patients with cystic fibrosis: a European Consensus. J Cyst Fibros 1:51–75.
View in Google Scholar

Kosińska M, Szwed A, Cieślik J, Goździk J, Cofta S. 2008. Biological status of adult patients with cystic fibrosis. J Physiol Pharmacol 59:341–8.
View in Google Scholar

Szwed A, John A, Gozdzik-Spychalska J, Czainski W, Czerniak W, Ratajczak J, Batura-Gabryel H. 2018. Survival of patients with cystic fibrosis depending on mutation type and nutritional status. Adv Exp Med Biol 1023:65–72.
View in Google Scholar

Pencharz PB, Durie PR. 2000. Pathogenesis of malnutrition in cystic fibrosis, and its treatment. Clin Nutr 19:387–94.
View in Google Scholar

Dray X, Kanaan R, Bienvenu T, Desmazes-Dufeu N, Dusser D, Marteau P, Hubert D. 2005. Malnutrition in adults with cystic fibrosis. Europ J Clin Nutri 59:152–54.de Gracia J, Mata F, Alvarez A, Casals T, Gatner S, Vendrell M, de la Rosa D, Guarner L, Hermosilla E. 2005.
View in Google Scholar

Genotype-phenotype correlation for pulmonary function in cystic fibrosis. Thorax 60:558–63.
View in Google Scholar

Shteinberg M, Downey DG, Beattie D, Mc-Caughan J, Reid A, Stein N, Elborn JS. 2017. Lung function and disease severity in cystic fibrosis patients heterozygous for p.Arg117His. ERJ Open Res 3(1):00056–2016.
View in Google Scholar

Alvarez JA, Ziegler TR, Millson EC, Stecenko AA. 2016. Body composition and lung function in cystic fibrosis and their association with adiposity and normal-weight obesity. Nutrition 32:447–52.
View in Google Scholar

Kerem E, Reisman J, Corey M, Canny GJ, Levison H. 1992. Prediction of mortality in patients with cystic fibrosis. N Engl J Med 326:1187–91.
View in Google Scholar

Milla CE. 2007. Nutrition and lung disease in cystic fibrosis. Clin Chest Med 28:319–30.
View in Google Scholar

Umławska W, Rams M. 2009. Physical development and pulmonary function in children and adolescents treated at two cystic fibrosis treatment centers in Poland. Arch Med Sci 5:583–8.
View in Google Scholar

Marín VB, Velandia S, Hunter B, Gattas V, Fielbaum O, Herrera O, Díaz E. 2004. Energy expenditure, nutrition status, and body composition in children with cystic fibrosis, Nutrition 20:181–6.
View in Google Scholar

Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gomez JM, Heitmann BL, Kent-Smith L, Melchior J-C, Pirlich M, Scharfetter H, Schols A., Pichard C. 2004. Composition of the ESPEN Working Group, Bioelectrical impedance analysis part I: review of principles and methods. Clin Nutr 23:1226–43.
View in Google Scholar

Richards ML, Bell SC, Edmiston KA, Davies PSW. 2003. Assessment of bioelectrical impedance analysis for the prediction of total body water in cystic fibrosis. Asia Pacific J Clin Nutr 12:16116–25.
View in Google Scholar

Grey AB, Ames RW, Matthews RD, Reid IR. 1993. Bone mineral density and body composition in adult patients with cystic fibrosis. Thorax 48:589–93.
View in Google Scholar

Ionescu AA, Nixon LS, Evans WD, Stone MD, Lewis-Jenkins V, Chatham K, Shale DJ. 2000. Bone density, body composition, and inflammatory status in cystic fibrosis. Am J Respir Crit Care Med 162:789–94.
View in Google Scholar

Matel JL, Milla CE. 2009. Nutrition in cystic fibrosis. Semin Respir Crit Care Med 30:579–86.
View in Google Scholar

Pedreira C, Robert R, Dalton V, Oliver MR, Carlin JB, Robinson P, Cameron FJ. 2005. Association of body composition and lung function in children with cystic fibrosis. Pediatr Pulmon 39:276–80.
View in Google Scholar

Zemel BS, Jawad AF, FitzSimmons S, Stallings VA. 2000. Longitudinal relationship among growth, nutritional status, and pulmonary function in children with cystic fibrosis: analysis of the Cystic Fibrosis Foundation National CF Patient Registry. J Pediatr 137:374–80.
View in Google Scholar

Schoni MH, Casaulta-Aebischer C. 2000. Nutrition and lung function in cystic fibrosis patients: review. Clin Nutr 19:79–85.
View in Google Scholar