超越BMI:CFTR调节器在囊性纤维化中的营养恢复和功能影响
Giovanna Linguiti1, Vanja Granberg1, Giuseppina Leonetti1
1Pediatric Unit "B. Trambusti", Cystic Fibrosis Regional Reference Center, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.
在囊性纤维化患者中,CFTR调节器显著改善BMI和肺功能 (FEV1). 虽然有益,但它们也增加了超重和肥胖的风险,需要专注于代谢健康而不仅仅是体重增加.
科学领域:
- 肺部病理学 肺部病理学
- 遗传学 是一个遗传学.
- 营养科学 营养科学
背景情况:
- 囊性纤维化 (CF) 是一种遗传性疾病,历史上与营养不良和严重疾病有关.
- CFTR调节器代表了一项突破,改变了患者的营养和功能状态.
- 了解这些变化对于优化CF护理至关重要.
研究的目的:
- 系统地审查CFTR调节剂对CF患者营养状况,身体组成和呼吸功能的影响.
- 分析BMI变化和调节器治疗后FEV1之间的关系.
- 评估更广泛的代谢影响并确定潜在的健康风险.
主要方法:
- 按照PRISMA指南进行系统审查.
- 分析了2012年至2025年间发表的17项研究.
- 包括儿科和成人CF群体.
主要成果:
- 在elexacaftor/tezacaftor/ivacaftor (ETI) 观察到显著的BMI增加 (+0.9至+1.6 kg/m2) 和FEV1改善 (7-13个百分点).
- 体重增加主要归因于脂肪量增加 (60-75%).
- 营养标志物 (白蛋白,前白蛋白,维生素) 的改善和减少炎症 (CRP,便calprotectin) 已注意到.
- 超重/肥胖 (高达40%) 和内脏脂肪的患病率增加.
结论:
- CFTR调节器为CF患者带来了巨大的营养和功能益处.
- 治疗需要转向优先考虑整体代谢健康,而不仅仅是体重增加.
- 战略应应对超重/肥胖和内脏脂肪的增加.
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