Excess weight in patients with cystic fibrosis: is it always beneficial?

David González Jiménez, Rosana Muñoz-Codoceo, María Garriga-García, Manuel Molina-Arias, Marina Álvarez-Beltrán, Ruth García-Romero, Cecilia Martínez-Costa, Silvia María Meavilla-Olivas, Luis Rodrigo Peña-Quintana, Silvia Gallego Gutiérrez, José Manuel Marugán de Miguelsanz, Lucrecia Suárez Cortina, Esperanza Natividad Castejón Ponce, Rosaura Leis Trabazo, Fayna Martín Cruz, Juan José Díaz Martín, Carlos Bousoño García


Introduction: The primary objective of this study was to find out the prevalence of overweight and obese status, as well as their association to pulmonary function, total cholesterol and vitamin D in patients with cystic fibrosis (CF).

Materials and methods: This is a multicenter descriptive and cross-sectional study. Twelve Spanish hospitals participated. 451 patients with CF were included. Adults were classified according to body mass index (BMI) and children were classified according to BMI percentiles (WHO tables). Pearson’s correlation, Anova, Student’s t-test and multiple linear regression were conducted.

Results: Mean age was 12.3 (range 4-57) years old, 51% were male and 18% had pancreatic sufficiency. Participants were classified in five nutritional status categories: 12% were malnourished; 57%, at nutritional risk; 24%, normally nourished; 6%, overweight; and 1%, obese. Pulmonary function in overweight or obese patients (91 ± 19%) was better than in malnourished patients (77 ± 24%) (p = 0.017). However, no difference was observed between those at nutritional risk (86 ± 19%) or normally nourished (90 ± 22%) groups. Overweight and obese patients had higher levels of total cholesterol (p = 0.0049), a greater proportion of hypercholesterolemia (p = 0.001), as well as lower levels of 25 OH
vitamin D (p = 0.058).

Conclusions: Prevalence of overweight and obese was 6 and 1%. Excess weight status does not offer any benefit in pulmonary function in comparison to normally nourished patients.

Palabras clave

Vitamin D. Cystic fibrosis. Overweight.

Texto completo:

PDF (English)


Cystic Fibrosis Foundation. Annual patient registry 2014. Available online: http://www.cff.org/LivingWithCF/QualityImprovement/PatientRegistryReport/. Accessed 30 March 2016.

Stephenson A.L., Mannik L.A., Walsh S, Brotherwood M., Robert R., Darling P.B., et al. Longitudinal trends in nutritional status and the relation between lung function and BMI in cystic fibrosis: a population-based cohort study. Am J ClinNutr.2013;97:872-877.

Hanna R.M., Weiner D.J. Overweight and obesity in patients with cystic fibrosis: a center-based analysis. PediatrPulmonol.2015;50:35-41.

Muñoz-Garach A., Cornejo-Pareja I., Tinahones F.J. Does Metabolically Healthy Obesity Exist? Nutrients.2016 1;8.

Chen W.L., Wang C.C., Wu L.W., Kao T.W., Chan J.Y., Chen Y.J., et al. Relationship between lung function and metabolic syndrome. PLoS One. 2014 9;9:e108989.

Kastner-Cole D., Palmer C.N., Ogston S.A.,Mehta A., Mukhopadhyay S. Overweight and obesity in deltaF508 homozygous cystic fibrosis. J Pediatr2005 ;147:402-404.

Sinaasappel M., Stern M., Littlewood J., Wolfe S., Steinkamp G., Heijerman H.G.M., et al. Nutrition in patients with cystic fibrosis: a European Consensus. J Cyst Fibros 2002;1:51-175.

WHOMulticentre Growth Reference Study Group. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: World Health Organization, 2006 (312 pages).

Borowitz D., Baker R.D., Stallings V. Consensus Report on nutrition for pediatric patients with cystic fibrosis. J PediatrGastroenterolNutr2002; 35: 246-259.

Leus J., Van Biervliet S., Robberecht E. Detection and follow up of exocrine pancreatic insuffieciency in cystic fibrosis: a review. Eur J Pediatr2000; 159 : 563-568.

Tangpricha V., Kelly A., Stephenson A., Enders J., Robinson K.A., Marshall B.C., et al. CysticFibrosisFoundationVitaminDEvidence-Based Review Committee. An update on the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis: evidence-based recommendations from the Cystic Fibrosis Foundation. J ClinEndocrinolMetab.2012 ;97:1082-1093.

Aitken M.L., Fiel S.B., Stern R.C. Cystic fibrosis: respiratory manifestations. Taussig LM, Landau LI (eds). Pediatric Respiratory Medicine. St Louis: CV Mosby ,1999. p. 1-47.

Martin J.J., Hernandez L.S., Gonzalez M.G., Mendez C.P., Rey Galán C., Guerrero S.M.Trends in childhood and adolescent obesity prevalence in Oviedo (Asturias, Spain) 1992-2006. ActaPaediatr2008; 97:955-958.

Baker J.F., Putman M.S., Herlyn K., Tillotson A.P., Finkelstein J.S., Merkel P.A.Body composition, lung function, and prevalent and progressive bone deficits among adults with cystic fibrosis. Joint BoneSpine.2016;83:207-211.

Alvarez J.A., Ziegler T.R., Millson E.C., Stecenko A.A. Body composition and lung function in cystic fibrosis and their association with adiposity and normal-weight obesity. Nutrition.2016 ;32:447-452.

Wortsman J., Matsuoka L., Chen T., Lu Z., Holick M.F.Decreased bioavailability of vitamin D in obesity. Am J ClinNutr2000;72: 690-693.

Rhodes B., Nash E.F., Tullis E., Pencharz P.B., Brotherwood M., Dupuis A.,et al.Prevalence of dyslipidemia in adults with cystic fibrosis.J CystFibros.2010 ;9:24-28.

Coderre L., Fadainia C., Belson L., Belisle V., Ziai S., Maillhot G., et al. LDL-cholesterol and insulin are independently associated with body mass index in adult cystic fibrosis patients. J Cyst Fibros. 2012 ;11:393-397.

Schwarzenberg S.J., Thomas W., Olsen T.W., Grover T., Walk D., Milla C., et al. Microvascular complications in cystic fibrosis-related diabetes. Diabetes Care May 2007;30:1056–1061.

Onady G.M., Farinet C.L. An adult cystic fibrosis patient presenting with persistent dyspnea: case report. BMC Pulm Med 2006;6:9.

Smith C., Winn A., Seddon P.,Ranganathan S.A fat lot of good: balance and trends in fat intake in children with cystic fibrosis. J Cyst Fibros.2012;11:154-157.

DOI: http://dx.doi.org/10.20960/nh.620

Enlaces refback

  • No hay ningún enlace refback.