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[Evaluation of the inflammatory and nutritional status in children with cystic fibrosis]
A Sarriá Chueca1, G Oliván Gonzalvo, A Lázaro Almarza
1Departamento de Pediatría, Facultad de Medicina, Universidad de Zaragoza.
Insights
This study introduces Nutritional-Inflammatory Prognostic Indices (NIPI) A and B to assess the nutritional and inflammatory status in cystic fibrosis (CF) patients. These indices, derived from plasma proteins, indicate an underlying inflammatory process in children with CF.
Area of Science:
- Biochemistry
- Pediatrics
- Clinical Nutrition
Background:
- Cystic Fibrosis (CF) management requires monitoring nutritional and inflammatory status.
- Assessing these conditions in CF patients during quiescent infection phases is challenging.
- Existing biomarkers may not comprehensively capture the complex interplay of nutrition and inflammation.
Purpose of the Study:
- To develop and validate novel indices for evaluating the nutritional and inflammatory status in pediatric cystic fibrosis patients.
- To identify sensitive, specific, and independent plasma proteins for this assessment.
- To establish simple formulas, Nutritional-Inflammatory Prognostic Indices (NIPI) A and B, for clinical application.
Main Methods:
- Quantification of four visceral proteins (albumin, thyroxine-binding prealbumin, retinol-binding protein, transferrin) and five acute-phase proteins (alpha-1-acid glycoprotein, alpha-1-antitrypsin, alpha-2-macroglobulin, haptoglobin, ceruloplasmin) in plasma.
- Analysis of plasma protein levels in 14 children with CF and 16 healthy children.
- Statistical-mathematical analysis to determine the most effective proteins and derive predictive index formulas.
Main Results:
- Established two novel indices: NIPI A (alpha-1-acid glycoprotein + haptoglobin/albumin + prealbumin) and NIPI B (haptoglobin/albumin).
- Identified specific plasma proteins that are sensitive, specific, and independent indicators of nutritional and inflammatory status.
- Demonstrated significant differences in protein profiles between CF patients and healthy controls.
Conclusions:
- The developed Nutritional-Inflammatory Prognostic Indices (NIPI) provide a reliable method for assessing nutritional and inflammatory conditions in cystic fibrosis patients.
- Children with cystic fibrosis exhibit an inflammatory process, likely infectious, even during periods of apparent inactivity.
- NIPI A and NIPI B offer a simplified approach to monitoring CF patients' health status.
Abstract:
The authors present a system for the appraisal of the nutritional and inflammatory condition in patients suffering from cystic fibrosis (CF) in the phase of apparent inactivity of pulmonary infection, using a system of indices based on the quantification of some plasmatic proteins. The plasmatic appraisals of 4 visceral proteins (albumin, thyroxine-binding prealbumin, retinol-binding protein and transferrin) and, as well, of 5 proteins of the acute phase (alpha-1-acid glycoprotein, alpha-1-antitrypsin, alpha-2-macroglobulin, haptoglobin and ceruloplasmin) were obtained in a control group of 16 healthy children and in another of 14 children affected by CF. With the proteic plasmatic appraisals of the control group, the knowledge of their biological value and after a statistical-mathematical analysis, the most sensitive, specific and independent proteins were determined for evaluating the nutritional and inflammatory condition, obtaining two simple formulas which were denominated Nutritional-Inflammatory Prognostic Indices (NIPI) A and B (NIPI A = alpha-1-acid glycoprotein + haptoglobin/albumin + prealbumin; NIPI B = haptoglobin/albumin). From the analysis of the results, it can be deduced that the children with CF are affected by an inflammatory process, very probably infectious.