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

J Cyst Fibros. 2020 Jan;19(1):139-145. doi: 10.1016/j.jcf.2019.10.004. Epub 2019 Nov 11.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • Cholesterol / blood*
  • Correlation of Data
  • Cystic Fibrosis* / complications
  • Cystic Fibrosis* / metabolism
  • Cystic Fibrosis* / physiopathology
  • Cystic Fibrosis* / therapy
  • Female
  • Heart Disease Risk Factors
  • Humans
  • Male
  • Malnutrition* / diagnosis
  • Malnutrition* / etiology
  • Malnutrition* / metabolism
  • Malnutrition* / prevention & control
  • Nutritional Status
  • Obesity* / blood
  • Obesity* / diagnosis
  • Obesity* / epidemiology
  • Obesity* / etiology
  • Overweight* / blood
  • Overweight* / diagnosis
  • Overweight* / epidemiology
  • Overweight* / etiology
  • Prevalence
  • Respiratory Function Tests / methods
  • Thinness* / diagnosis
  • Thinness* / etiology
  • Thinness* / metabolism
  • Thinness* / prevention & control
  • United States / epidemiology

Substances

  • Cholesterol