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Published on: August 3, 2021
Body composition and pulmonary function in cystic fibrosis
Saba Sheikh1, Babette S Zemel2, Virginia A Stallings2
1Division of Pulmonary Medicine, Cystic Fibrosis Center, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, PA , USA ; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, PA , USA.
Lean body mass (LBM) is a better indicator of lung function in cystic fibrosis (CF) patients than body mass index (BMI). LBM is especially important for undernourished youth with CF.
Area of Science:
- Pediatric Pulmonology
- Body Composition Analysis
- Nutritional Status in Chronic Disease
Background:
- Lower body mass index (BMI) is linked to poorer pulmonary function in cystic fibrosis (CF).
- The relationship between body composition and lung function in CF requires further elucidation.
Purpose of the Study:
- To investigate whether lean body mass (LBM) or fat mass index (FMI) is more strongly associated with pulmonary function than BMI in youth with pancreatic insufficient CF (PI-CF).
Main Methods:
- Dual-energy X-ray absorptiometry (DXA) was used to assess body composition in 208 PI-CF youth and 390 controls.
- Sex- and age-adjusted Z-scores for BMI, LBM, and FMI were calculated.
- Associations between BMI, LBM, and FMI with FEV1% predicted were analyzed.
Main Results:
- PI-CF youth exhibited lower BMI, LBM, and FMI Z-scores compared to controls.
- BMI was positively associated with LBM in PI-CF subjects (p < 0.0001).
- In both sexes, LBM index (LBMI-Z) and BMI (BMI-Z) were positively associated with FEV1%-predicted; FMI-Z was not independently associated with lung function.
Conclusions:
- Deficits in LBM are evident in PI-CF youth.
- BMI may not accurately reflect LBM in PI-CF, particularly at lower BMI percentiles.
- LBMI-Z, not FMI-Z, is positively associated with pulmonary function in undernourished PI-CF youth, highlighting its importance for lung health.
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