Association of growth and nutritional parameters with pulmonary function in cystic fibrosis: a literature review

Mauch, Renan Marrichi; Kmit, Arthur; Marson, Francesco; Levy, Carlos Emílio; Filho, Antônio de Azevedo Barros; Ribeiro, José Dirceu

doi:10.1016/j.rppede.2016.02.001

Cited by 17 publications

(13 citation statements)

References 28 publications

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“…A similar case might also apply for FEV 1 . Consistent with the existing literature [32], patients at malnutrition risk exhibited worse pulmonary function. Notably, even though the moderate malnutrition risk group demonstrated an impaired mean pulmonary function than the low-risk group, 38% of the patients with moderate malnutrition risk exhibited an adequate lung function (predicted FEV 1 ≥ 90%).…”

Section: Discussionsupporting

confidence: 90%

Triage for Malnutrition Risk among Pediatric and Adolescent Outpatients with Cystic Fibrosis, Using a Disease-Specific Tool

et al. 2020

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Malnutrition prevails in considerable proportions of children with Cystic Fibrosis (CF), and is often associated with adverse outcomes. For this, routine screening for malnutrition is pivotal. In the present cross-sectional study, we aimed to assess the risk for malnutrition in pediatric outpatients with CF. A total of 76 outpatients (44 girls, 11.9 ± 3.9 years old, 39.5% adolescents) were recruited and anthropometric, clinical, dietary and respiratory measures were collected. All outpatients were screened for malnutrition risk with a validated disease-specific instrument. Most children exhibited a low risk for malnutrition (78.9%), whereas none of the participants were characterized as having a high malnutrition risk. In the total sample, malnutrition risk was positively associated with age (r = 0.369, p = 0.001), and inversely related to the body mass index (r = −0.684, p < 0.001), height z-score (r = −0.264, p = 0.021), and forced expiratory volume (FEV1%, r = −0.616, p < 0.001). Those classified as having a low malnutrition risk were younger (p = 0.004), heavier (p < 0.001) and taller (p = 0.009) than their counterparts with a moderate risk. On the other hand, patients in the moderate risk group were more likely pubertal (p = 0.034), with a reduced mid-upper arm fat area (p = 0.011), and worse pulmonary function (p < 0.001). Interestingly, none of the children attaining ideal body weight were classified as having a moderate malnutrition. risk, whereas 37.5% of the patients allocated at the moderate risk group exhibited physiological lung function. In this cohort of outpatients with CF that were predominantly well-nourished and attained physiological lung function, malnutrition risk was identified only in small proportions of the sample. Our data support that patients that are older, pubertal, or have diminished fat mass are at greater risk for malnutrition.

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Section: Discussionsupporting

confidence: 90%

Triage for Malnutrition Risk among Pediatric and Adolescent Outpatients with Cystic Fibrosis, Using a Disease-Specific Tool

et al. 2020

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“…Australia also delivered more aggressive treatment for pulmonary exacerbations, which contributes to better lung health . Despite the very strong correlation between nutritional outcomes and lung health, FEV 1 were actually similar between Australian and US children . In fact, Australian children had significantly lower FEV 1 after adjusting for the mode of diagnosis .…”

Section: Discussionmentioning

confidence: 99%

The importance of data issues when comparing cystic fibrosis registry outcomes between countries: Are annual review FEV₁ in the UK only collected when subjects are well?

Hoo

Curley

Campbell

et al. 2018

Evaluation Clinical Practice

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Rationale, aims and objectiveCross‐country comparisons of cystic fibrosis (CF) outcomes can potentially identify variation in care but are dependent on data quality. An important assumption is that the UK annual review FEV1 is only collected during periods of clinical stability. If this assumption does not hold, results of FEV1 comparisons may be biased in favour of registries with encounter‐based FEV1. We aimed to test the assumption that CF annual reviews in the UK are only performed during periods of clinical stability.MethodProspective encounter‐based data collected in Sheffield (n = 174) was used to establish whether annual review FEV1 were always collected during periods of clinical stability and to determine the group‐level discrepancy between annual review vs best FEV1. We then went on to quantify the group‐level discrepancy between annual review and best annual FEV1 readings within the UK registry (n = 2995) to determine if the differences observed in Sheffield also apply to the wider UK data.ResultsSheffield results showed a group‐level discrepancy between best and annual review FEV1 of −2.5% (95% CI −3.95% to −1.2%) for annual reviews performed during periods of clinical stability (n = 50). The group‐level discrepancy is larger at −8.0% (95% CI −11.2% to −4.9%) among annual reviews performed during periods of clinical instability (n = 13). Therefore, the magnitude of this group‐level discrepancy is a surrogate for the proportion of clinically stable annual reviews—smaller discrepancy indicates a higher proportion of clinically stable annual reviews and vice versa.The overall group‐level discrepancy in the UK registry (−5.6%, 95% CI −5.9 to −5.4%) was similar to Sheffield (−6.1%, 95% CI −7.1 to −5.1%). Around 20% of the clinician reviewed, annual reviews in Sheffield were performed during periods of clinically instability.ConclusionsAnnual review FEV1 underestimates lung health of adults with CF in the UK and may bias cross‐country comparisons.

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“…Este resultado reflete a preocupação dos responsáveis com as deficiências nutricionais provocadas pela doença e com a dificuldade dos filhos para atingirem o peso ideal para a faixa etária. [25][26][27][28] O fato de a maioria dos pacientes se apresentarem eutróficos no momento da avaliação se deve possivelmente à atuação da equipe interdisciplinar, incluindo nutricionista e fisioterapeuta, que participam do acompanhamento de todos os pacientes do programa, como preconizado pelas diretrizes atuais de tratamento da FC. 25 Em outro estudo brasileiro, realizado no estado de São Paulo, o domínio "peso" também recebeu a pontuação mais baixa na percepção dos pais.…”

Section: Discussionunclassified

“…Embora esta relação não tenha sido observada em outros estudos realizados com adolescentes e adultos, 22 está bem estabelecido na literatura que o estado nutricional tem relação com a severidade do comprometimento da função pulmonar em pacientes com FC. [26][27][28]33 Corroborando outros estudos, 22,34 foi observada correlação positiva forte entre o domínio "imagem corporal" e o pIMC/I, indicando que quanto menor é o peso, pior é a imagem corporal. Esse resultado merece atenção, tendo em vista que "imagem corporal" e "peso" foram os dois domínios com pior pontuação, conforme discutido em parágrafos anteriores, o que significa que são os que apresentaram impacto mais negativo na QV das crianças e adolescentes com FC, de acordo com sua própria percepção, e também na percepção de seus responsáveis, no caso do domínio "peso".…”

Section: Discussionunclassified

Qualidade De Vida De Crianças E Adolescentes Com Fibrose Cística: Importância Da Imagem Corporal E Impacto Do Estado Nutricional, Idade E Raça/Cor Na Percepção Dos Pacientes E Responsáveis

Silva¹,

Lima²,

Wittmer³

et al. 2018

DEMETRA

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ResumoObjetivo: Identificar os principais fatores relacionados à qualidade de vida de crianças e adolescentes com fibrose cística. Métodos: Estudo transversal, com indivíduos com fibrose cística, entre 7 e 18 anos, de um Centro de Referência Estadual. A qualidade de vida foi avaliada com o Cystic Fibrosis Questionnaire. Testes usados na análise estatística: Mann-Whitney e Correlação de Spearman. Nível de significância adotado: 5%. Resultados: Na percepção dos pacientes, os domínios da qualidade de vida com piores médias foram imagem corporal (64,3±29,6) e peso (47,6±42,4). Na percepção dos responsáveis, peso também apresentou a pior média (52,8±43,7). O impacto dos tratamentos na qualidade de vida foi maiora partir dos 14 anos (p=0,012), e o impacto da alimentação foi maior entre menores de 14 anos (p=0,04). Indivíduos brancos apresentaram melhores escores do que negros/pardos no domínio imagem corporal (p=0,049). Houve correlação positiva moderada entre pIMC/I e o domínio respiratório e correlação positiva forte entre pIMC/I e imagem corporal. Conclusões: A correlação entre pIMC/I e imagem corporal sugere que o baixo-peso afeta negativamente a imagem corporal, o que merece atenção, pois imagem corporal e peso foram os domínios com piores pontuações na percepção dos pacientes, sendo que o peso também teve a pior pontuação na percepção dos responsáveis. Além disso, o baixo-peso aumentou o impacto dos sintomas respiratórios na qualidade de vida. O impacto dos tratamentos aumentou com a idade, enquanto o da alimentação diminuiu com a idade. Também se observou impacto da raça/cor no domínio imagem corporal da qualidade de vida.DOI: 10.12957/demetra.2018.32295

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Association of growth and nutritional parameters with pulmonary function in cystic fibrosis: a literature review

Cited by 17 publications

References 28 publications

Triage for Malnutrition Risk among Pediatric and Adolescent Outpatients with Cystic Fibrosis, Using a Disease-Specific Tool

Triage for Malnutrition Risk among Pediatric and Adolescent Outpatients with Cystic Fibrosis, Using a Disease-Specific Tool

The importance of data issues when comparing cystic fibrosis registry outcomes between countries: Are annual review FEV₁ in the UK only collected when subjects are well?

Qualidade De Vida De Crianças E Adolescentes Com Fibrose Cística: Importância Da Imagem Corporal E Impacto Do Estado Nutricional, Idade E Raça/Cor Na Percepção Dos Pacientes E Responsáveis

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Association of growth and nutritional parameters with pulmonary function in cystic fibrosis: a literature review

Cited by 17 publications

References 28 publications

Triage for Malnutrition Risk among Pediatric and Adolescent Outpatients with Cystic Fibrosis, Using a Disease-Specific Tool

Triage for Malnutrition Risk among Pediatric and Adolescent Outpatients with Cystic Fibrosis, Using a Disease-Specific Tool

The importance of data issues when comparing cystic fibrosis registry outcomes between countries: Are annual review FEV1 in the UK only collected when subjects are well?

Qualidade De Vida De Crianças E Adolescentes Com Fibrose Cística: Importância Da Imagem Corporal E Impacto Do Estado Nutricional, Idade E Raça/Cor Na Percepção Dos Pacientes E Responsáveis

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The importance of data issues when comparing cystic fibrosis registry outcomes between countries: Are annual review FEV₁ in the UK only collected when subjects are well?