Hidden Depletion of Fat-Free Mass and Bone Mineral Density in Adults With Cystic Fibrosis

Ionescu, Alina; Evans, W. D.; Pettit, Rebecca; Nixon, Lisette Sheena; Stone, Michael D.; Shale, Dennis J.

doi:10.1378/chest.124.6.2220

Cited by 70 publications

(64 citation statements)

References 38 publications

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“…These findings are consistent with previous investigations, which found BMI to be normal in 40% of nutritionally depleted CF patients [44] with many CF patients with normal BMI showing dissociation in the relationship between BMI and the impairment of lung function. In the healthy subjects FFM was within the limits of a healthy UK population of the same age and sex, although these data were generated from bioelectrical impedance.…”

Section: Discussionsupporting

confidence: 93%

The influence of body composition on respiratory muscle, lung function and diaphragm thickness in adults with cystic fibrosis

Enright

Chatham

Ionescu

et al. 2007

Journal of Cystic Fibrosis

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Section: Discussionsupporting

confidence: 93%

The influence of body composition on respiratory muscle, lung function and diaphragm thickness in adults with cystic fibrosis

Enright

Chatham

Ionescu

et al. 2007

Journal of Cystic Fibrosis

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“…There were no data on the loss of fat-free mass. Loss of fat-free mass has been associated with reduced BMD and more severe COPD, and might be a more concise marker of severity of OAD compared with BMI [42,43]. Although the current authors did not have data on BMI for all patients, the present finding of an inverse relationship between BMI and fracture risk was consistent with those previously reported [44,45].…”

Section: Disease Severity and Fracture Risk F De Vries Et Alsupporting

confidence: 89%

Severity of obstructive airway disease and risk of osteoporotic fracture

Vries

Staa²,

Bracke³

et al. 2005

European Respiratory Journal

126

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The use of inhaled corticosteroids has been associated with a dose-related increased risk of fracture. This may be related to systemic absorption. However, several studies have found that patients with more severe reductions in pulmonary function had reduced bone mineral density, independent of inhaled corticosteroids. The objective of this study was to evaluate the relationship between disease severity and fracture risk.A large case-control study (108,754 cases) was conducted using data from the UK General Practice Research Database. It was found that higher doses of inhaled corticosteroids were associated with greater risks of fracture. The crude odds ratio of fracture among patients exposed to .1,600 mg beclomethasone equivalents per day was 1.95 (95% confidence interval (CI) 1.68-2.27). When adjustments were made for disease severity and use of bronchodilators, the initial dose-response relationship between inhaled corticosteroids and fracture risk disappeared (adjusted odds ratio of 1.19 (95% CI 1.01-1.41)).In conclusion, patients with severe obstructive airway disease are at risk of fracture. However, adequate adjustment for disease severity is essential when the association between the use of inhaled corticosteroids and risk of osteoporotic fracture is studied in observational research.

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“…None None Able to discriminate between CF and healthy a Within CF able to discriminate between different fat free mass, different lung function a [35][36][37] Evidence of significant correlation between lung function a and bone mineral density a, b [35,36,38] None Harvard Alumni Survey Evidence of reliability over 3 time points c [28] Evidence of correlation with activity monitors (Caltrac [42] Evidence of significant correlation with lung function a [42] None Bouchard Diary None Evidence of correlation with HAES b, c [9] Able to discriminate between CF and healthy b, c Within CF able to discriminate between CF PI and PS b [15] Evidence of significant correlation with exercise capacity, quality of wellbeing and body mass percentile a, b [15] None Bratteby Diary Reliable over two points in time a, b, c [25] Evidence of correlation with activity monitors (Actigraph) a, b, c and physical activity questionnaires (HAES) a, b, c [25] None None Responsive to inpatient training c [43] a Adults. b Adolescents.…”

Section: Reliabilitymentioning

confidence: 99%

Physical activity assessment in cystic fibrosis: A position statement

Bradley

O’Neill

Kent

et al. 2015

Journal of Cystic Fibrosis

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Our current position is that activity monitors such as SenseWear or ActiGraph offer informed choices to facilitate a comprehensive assessment of physical activity, and should as a minimum report on dimensions of physical activity including energy expenditure, step count and time spent in different intensities and sedentary time. The DigiWalker pedometer offers an informed choice of a comparatively inexpensive method of obtaining some measurement of physical activity. The HAES represents an informed choice of questionnaire to assess physical activity. There is insufficient data to recommend the use of one diary over another. Future research should focus on providing additional evidence of clinimetric properties of these and new physical activity assessment tools, as well as further exploring the added value of physical activity assessment in CF.

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Hidden Depletion of Fat-Free Mass and Bone Mineral Density in Adults With Cystic Fibrosis

Cited by 70 publications

References 38 publications

The influence of body composition on respiratory muscle, lung function and diaphragm thickness in adults with cystic fibrosis

The influence of body composition on respiratory muscle, lung function and diaphragm thickness in adults with cystic fibrosis

Severity of obstructive airway disease and risk of osteoporotic fracture

Physical activity assessment in cystic fibrosis: A position statement

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