Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
J Cyst Fibros. 2022 Jan;21(1):111-114. doi: 10.1016/j.jcf.2021.05.002. Epub 2021 May 27.
Over the last decades aggressive interventions have been successful to improve nutritional outcomes in people with cystic fibrosis (CF). As a result, with improvement of life expectancy and new CFTR modulators, overweight and obesity are progressively becoming a source of concern for adult population and in developed countries.
This was a multicenter, observational, cross-sectional study of 321 adults with CF at three large CF centers in Italy. Patients were divided into three groups according to BMI classes, overweight and obesity (OW) group including patients with BMI ≥25 kg/m, normal weight (NW) group with BMI 18.6-24.9 kg/m and underweight (UW) group with BMI ≤18.5 kg/m.
We demonstrated that prevalence of OW in adults with CF in Italy is 22%. OW status is independently associated with male sex (OR 3.520, P = 0.001), pancreatic sufficiency (OR 2.873, P = 0.014) and older age at diagnosis (1.015, P = 0.042). BMI correlated with ppFEV1 (r = 0.337; P<0.0001) with median ppFEV1 significantly higher in patients with OW than comparisons. We also reported preliminary data on unfavorable cardiovascular risk factors in a subgroup of patients, where median blood levels [IQR] of cholesterol and systemic hypertension [%] were significantly higher in the OW group than in the NW and UW.
People with CF and OW is a relevant patient group that might deserve better definition and proper clinical management.
在过去的几十年中,积极的干预措施成功地改善了囊性纤维化(CF)患者的营养状况。因此,随着预期寿命的延长和新的 CFTR 调节剂的出现,超重和肥胖逐渐成为成年人和发达国家关注的问题。
这是一项在意大利三个大型 CF 中心进行的多中心、观察性、横断面研究,共纳入 321 名成年 CF 患者。根据 BMI 类别将患者分为三组,超重和肥胖(OW)组包括 BMI≥25kg/m 的患者,正常体重(NW)组 BMI 为 18.6-24.9kg/m,体重不足(UW)组 BMI≤18.5kg/m。
我们表明,意大利 CF 成人中 OW 的患病率为 22%。OW 状态与男性(OR 3.520,P=0.001)、胰腺功能充分(OR 2.873,P=0.014)和诊断时年龄较大(OR 1.015,P=0.042)独立相关。BMI 与 ppFEV1 相关(r=0.337;P<0.0001),OW 患者的 ppFEV1 中位数明显高于对照组。我们还报告了亚组患者中不利心血管危险因素的初步数据,OW 组的胆固醇和系统性高血压的中位血水平 [IQR] [百分位数]明显高于 NW 和 UW 组。
CF 合并 OW 的患者是一个重要的患者群体,可能需要更好的定义和适当的临床管理。