Ventura Julia Carvalho, Hauschild Daniela Barbieri, Moreira Emília Addison Machado, Pereira Letícia Cristina Radin, Rosa Anauã Franco, Barbosa Eliana, Ludwig-Neto Norberto, Rosa Julia Salvan da, Fröde Tânia Silvia, Moreno Yara Maria Franco
MSc. Doctoral Student, Postgraduate Program on Nutrition, Universidade Federal de Santa Catarina (UFSC), Florianópolis (SC), Brazil.
PhD. Professor, Department of Nutrition and Postgraduate Program on Nutrition, Universidade Federal de Santa Catarina (UFSC), Florianópolis (SC), Brazil.
Sao Paulo Med J. 2018 Jan-Feb;136(1):29-36. doi: 10.1590/1516-3180.2017.0109100917. Epub 2017 Dec 18.
Chronic lung infections, inflammation and depletion of nutritional status are considered to be prognostic indicators of morbidity in patients with cystic fibrosis. The aim of this study was to investigate the association between inflammatory markers and lung function, nutritional status and morbidity among children/adolescents with cystic fibrosis.
Prospective three-year longitudinal study conducted in an outpatient clinic in southern Brazil.
Children/adolescents aged 1-15 years with cystic fibrosis were enrolled. Nutritional status was determined from weight-to-length and body mass index-to-age z-scores and was classified as acceptable, at risk or nutritional failure. Tumor necrosis factor-α, interleukin-1β, myeloperoxidase, C-reactive protein and C-reactive protein/albumin ratio were analyzed. Lung function was evaluated based on the forced expiratory volume in the first second and morbidity according to the number of hospitalizations for pulmonary exacerbation and infections by Pseudomonas aeruginosa. Lung function, nutritional status and morbidity were the outcomes. Odds ratios and 95% confidence intervals were to evaluate the effect of baseline inflammatory markers on the clinical outcomes after three years of follow-up and p-values < 0.05 were considered significant.
We evaluated 38 children/adolescents with cystic fibrosis: 55% female; median age (with interquartile range), 3.75 years (2.71-7.00). Children/adolescents with high C-reactive protein/albumin ratio at baseline had odds of 18 (P = 0.018) of presenting forced expiratory volume in the first second ≤ 70% after three years. The other inflammatory markers were not associated with the outcomes.
C-reactive protein/albumin ratio was associated with forced expiratory volume in the first second ≤ 70% after three years.
慢性肺部感染、炎症以及营养状况的消耗被认为是囊性纤维化患者发病的预后指标。本研究的目的是调查囊性纤维化儿童/青少年中炎症标志物与肺功能、营养状况及发病率之间的关联。
在巴西南部的一家门诊诊所进行的为期三年的前瞻性纵向研究。
纳入1至15岁的囊性纤维化儿童/青少年。根据体重与身长、体重指数与年龄的z评分确定营养状况，并将其分类为可接受、有风险或营养衰竭。分析肿瘤坏死因子-α、白细胞介素-1β、髓过氧化物酶、C反应蛋白及C反应蛋白/白蛋白比值。根据第一秒用力呼气量评估肺功能，并根据肺部加重和铜绿假单胞菌感染的住院次数评估发病率。肺功能、营养状况和发病率为研究结果。采用比值比和95%置信区间评估基线炎症标志物对三年随访后临床结局的影响，p值<0.05被认为具有统计学意义。
我们评估了38例囊性纤维化儿童/青少年：55%为女性；中位年龄（四分位间距）为3.75岁（2.71 - 7.00）。基线时C反应蛋白/白蛋白比值高的儿童/青少年在三年后第一秒用力呼气量≤70%的几率为18（P = 0.018）。其他炎症标志物与研究结果无关。
C反应蛋白/白蛋白比值与三年后第一秒用力呼气量≤70%相关。
