Resting energy expenditure and lung disease in cystic fibrosis

Abstract

Optimal nutritional support is considered to be an integral part in the management of cystic fibrosis (CF). Several factors contribute to increased resting energy expenditure (REE), which itself can lead to energy imbalance and thus contribute to deterioration of the nutritional status. We aimed to assess the impact of lung parenchyma damage on REE and correlated these findings with forced expiratory volume in 1 s (FEV(1)). Twenty patients performed respiratory function testing (FEV(1)), pulmonary high-resolution computed tomography (HRCT) and assessment of REE with open circuit indirect calorimetry. HRCT was scored by using a modified Bhalla method. Mean HRCT score was 8.4 and mean REE value was 108.4% predicted vs. 96.5% predicted of 16 healthy subjects (P<0.01). There was a significant correlation between HRCT score and REE (P<0.01), HRCT score and FEV(1) (P<0.001) and REE and FEV(1) (P<0.05). The correlations demonstrate a close correlation between lung damage and elevated REE in people with CF. Prevention of negative energy balance is an important part in follow-up of patients with CF. Any increase in REE should raise suspicion of progress in lung impairment.

Genome-wide association and linkage identify modifier loci of lung disease severity in cystic fibrosis at 11p13 and 20q13.2

“…Among the five genes, MC3R has been implicated in weight maintenance and regulation of energy balance in animals and humans 34-36 . Variation in resting energy expenditure has been correlated with lung function measurements, lung tissue damage and lung disease exacerbation in CF patients 37,38 . MC3R has also been implicated as a modulator of neutrophil accumulation in a murine model of lung inflammation 39 , a key feature of CF lung disease, as noted above.…”

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

“…Growth retardation and undernutrition are often seen in patients with cystic fibrosis (CF) as a result of several factors including malabsorption [1,2], reduced energy intake [3], increased energy expenditure [4,5] and the inflammatory state secondary to chronic pulmonary infection [6]. Such events lead to loss of fat mass and fat-free mass (FFM).…”

Oral protein energy supplements for children with cystic fibrosis: CALICO multicentre randomised controlled trial

“…They are used in the medium to long term when weight gain is not satisfactory or in the short term to enable weight that has been lost acutely to be regained. They are considered an acceptable, non-invasive means of improving nutritional status and overall prognosis in children who have increased energy requirements 11. However, many people find them unpalatable, particularly when prescribed for long term use.…”