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Published on: September 13, 2018
[Resting energy expenditure in cystic fibrosis]
R Cancho Candela1, M Alonso-Franch, C Calvo Romero
1Departamento de Pediatría, Hospital Clínico Universitario, Facultad de Medicina, Valladolid, España.
Insights
Resting energy expenditure (REE) is elevated in cystic fibrosis (CF) patients and strongly correlates with fat-free mass and pulmonary disease severity. Lower vitamin E to cholesterol ratios also indicate increased REE in CF.
Area of Science:
- Metabolic research
- Clinical nutrition
- Pulmonology
Context:
- Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs, including the lungs and digestive system.
- Patients with CF often experience increased energy demands due to chronic inflammation and infection.
- Understanding Resting Energy Expenditure (REE) is crucial for optimizing nutritional management in CF.
Purpose:
- To investigate Resting Energy Expenditure (REE) in pediatric and adolescent patients with Cystic Fibrosis (CF) using indirect calorimetry.
- To determine the relationship between REE and various clinical, nutritional, and biochemical parameters in CF patients.
- To identify factors contributing to altered energy metabolism in CF.
Summary:
- Indirect calorimetry revealed elevated REE in CF patients, averaging 104.2% of predicted values.
- REE showed a strong positive correlation with fat-free mass (r=0.92) and bioelectrical impedance parameters (r=0.89).
- Increased REE was significantly associated with poorer pulmonary function (FEV1, Chrispin Score) and a decreased Vitamin E/cholesterol ratio.
Impact:
- Findings highlight the importance of assessing REE in CF for accurate caloric needs estimation.
- The correlation with pulmonary disease severity suggests a link between inflammation and hypermetabolism.
- Altered lipid profiles, specifically lower Vitamin E/cholesterol, may serve as indicators of increased energy expenditure in CF.
Objective:
Study of Resting Energy Expenditure (REE) by indirect calorimetry in patients with Cystic Fibrosis (CF), with the aim of determine its possible increase and its relationship with nutritional clinic and analitic parameters.
Patients And Methods:
Measurement of REE in 18 patients (11 female) with CF, without acute pulmonary exacerbation. Their age was between 5 years 3 months and 21 years 7 months. REE was expressed as kcal/day and as percentage of the predictive education of World Health Organization (WHO) for calculation of REE in function of gender, age and weight. It was also determined complete anthropometry and body composition derived (Siri), bioelectrical impedance, pulmonary function (FEV1 and FVC), chest X-ray (Score Chrispin) and blood sample (leucocits, VSG, IgM, vitamin A, C, E and serum lipids).
Results:
The mean REE was 1280 +/- 246 kcal/day. There was strong correlation with fat free mass (anthropometry) (r: 0.92; p < 0.0001) and with ratio height 2/resistance by bioelectric impedance (r: 0.89; p < 0.0001). If expressed as percentage of WHO education, REE was 104.2 +/- 9.8%. In chronic infected by Pseudomona sp. was 106.8 +/- 11.5% and 101.0 +/- 6.6 in no infected patients. REE was 102.9 +/- 6.4% in prepubertal subjects, 102.2 +/- 10.8% in pubertal, and 108.6 +/- 12.1 in postpubertal subjects. There was no significative correlation with nutritional status, but it was reported significative correlation with severity of pulmonary disease (FEV1: r: -0.58; p < 0.05. Score Chrispin: r: 0.62; p < 0.005). There was also significative correlation with ratio vitamin E/cholesterol (r: -0.60; p < 0.05), but not with another analitic parameters.
Conclusions:
REE is strong correlated with fat free mass in patients with CF. The increased REE values over normal ones is related with severity of pulmonary disease. The decrease of ratio Vitamin E/cholesterol is also related with increase of REE.
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