Prevalence and factors associated with overweight and obesity in adults with cystic fibrosis: A single-center analysis

Abstract

Background: The relation between malnutrition and pulmonary death in patients with cystic fibrosis (CF) has resulted in intensive nutritional intervention over the last few decades, leading to a significant decline in underweight and the emergence of overweight/obesity as a potential new problem.

Methods: We performed a cross-sectional database analysis of 484 adults with CF seen at the University of Minnesota CF Center between January 2015-January 2017, to determine the prevalence and pulmonary/cardiovascular risk factors associated with overweight and obesity in this population.

Results: Mean age was 35.2 ± 11.6 years. 5.2% were underweight (BMI<18.5 kg/m2), 62.6% normal weight (BMI ≥ 18.5-24.9 kg/m2), 25.6% overweight (BMI ≥ 25-29.9 kg/m2) and 6.6% obese (BMI ≥ 30 kg/m2). In the subgroup with severe genotypes, 25% had BMI ≥ 25 kg/m2. In the entire cohort, overweight/obese were likely to be older (OR = 1.04, p < 0.0001) and to have a mild CFTR genotype (OR = 3.33, p = 0.0003) and modestly elevated triglyceride levels (OR = 1.008, p < 0.0001). The prevalence of hypertension was higher in overweight (25%) and obese (31%) than normal (17%) or underweight (16%), p = 0.01. Total cholesterol levels were higher in overweight/obese versus normal/underweight (144-147 vs 123-131 mg/dL, p = 0.04) as were LDL levels (70-71 vs 53-60 mg/dL, p = 0.02), but all were within the normal range. Percent predicted FEV1 was higher in overweight/obese (78-81%) versus underweight (59%) and normal (70%), p < 0.0001, and overweight/obese experienced significantly fewer acute pulmonary exacerbations.

Conclusions: Overweight/obesity is common in adults with CF including those with severe genotypes. Lung function is better in the overweight/obese and lipid levels are within the normal range, albeit higher than in normal/underweight.

Keywords: Cystic Fibrosis; Obesity; Prevalence.

Conflict of interest statement

Declaration of Competing Interest T. Harindhanavudhi, A. Moheet, A. Moran and Q. Wang have no competing interests. J. Dunitz has received grants from Vertex Pharmaceuticals Inc, Hillrom, Proteostasis Therapeutics, Inc, and Cystic Fibrosis Foundation independent from the submitted work.

Copyright © 2019 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Figures

Fig. 1.

Loess fit curve between body mass index (BMI) and FEV1% predicted in all study cohort. BMI; Body mass index, FEV1% predicted; forced expiratory volume in 1 s expressed as a percentage of the normal predicted values for height and sex.