The role of daily physical activity and nutritional status on bone turnover in cystic fibrosis: a cross-sectional study

Abstract

BackgroundNutritional status and daily physical activity (PA) may be an excellent tool for the maintenance of bone health in patients with cystic fibrosis (CF).ObjectiveTo evaluate the relationship between nutritional status, daily physical activity and bone turnover in cystic fibrosis patients.MethodA cross-sectional study of adolescent and adult patients diagnosed with clinically stable cystic fibrosis was conducted. Total body, femoral neck, and lumbar spine bone mineral density (BMD) were determined by dual energy X-ray absorptiometry and bone metabolism markers ALP, P1NP, PICP, and ß-CrossLaps. PA monitoring was assessed for 5 consecutive days using a portable device. Exercise capacity was also determined. Serum 25-hydroxyvitamin D and vitamin K were also determined in all participants.ResultsFifty patients (median age: 24.4 years; range: 16-46) were included. BMI had positive correlation with all BMD parameters, with Spearman’s coefficients ranging from 0.31 to 0.47. Total hip bone mineral density and femoral neck BMD had positive correlation with the daily time spent on moderate PA (>4.8 metabolic equivalent-minutes/day; r=0.74, p<0.001 and r=0.72 p<0.001 respectively), daily time spent on vigorous PA (>7.2 metabolic equivalent-minutes/day; r=0.45 p<0.001), body mass index (r=0.44, p=0.001), and muscle mass in limbs (r=0.41, p=0.004). Levels of carboxy-terminal propeptide of type 1 collagen were positively associated with the daily time spent on moderate (r=0.33 p=0.023) and vigorous PA (r=0.53, p<0.001).ConclusionsBMI and the daily time spent on moderate PA were found to be correlated with femoral neck BMD in CF patients. The association between daily PA and biochemical markers of bone formation suggests that the level of daily PA may be linked to bone health in this patient group. Further research is needed to confirm these findings.

Physical Activity Levels and Performance in Italian Adolescents with Cystic Fibrosis: A Multicenter Cross-sectional Study

“…Nixon et al [9] found no correlation between the reported time spent in vigorous activities and maximal oxygen uptake (V'O 2 peak) in 30 subjects aged 7-19 years. Schneidermann et al [5] found no significant association between V'O 2 peak and habitual PA. Controversially another author speculated that PA could be a significant, although relatively weak, predictor of V'O 2 peak in CF [8]. The positive relationship between PA levels and aerobic fitness is supported by a recent study by Savi et al [22].…”

“…A growing body of research has demonstrated that exercise training and physical activity (PA) are associated with decreased mortality [3], slower rate of decline in respiratory function [4,5], higher bone mineral density [6], improved nutritional status and health-related quality of life [7].…”

“…Regarding pulmonary function, some authors reported that higher PA levels were associated with a slower rate of decline in FEV 1 , specifically in girls with CF [5,11]. Considering these findings and given that many adolescents fail to reach the recommended level of PA, there is the need to ensure that youth are meeting the PA guidelines recommended for optimal health outcomes.…”

Tools and Methods Used for the Assessment of Body Composition in Patients With Cystic Fibrosis: A Systematic Review

“…Forty‐one studies (33.1%) recruited adult patients aged between 18 and 57 years and a total number of 1983 patients with CF. Only 15 studies included patients older than 40 years . Ten studies (8.1%) included both children and adults (range: 4–66 years, N = 768).…”

“…DXA was used in 56 studies (33.9%, see Tables and for details), whereas 12 studies (9.7%) used only BIA; 5 studies (4%) applied SF, and 5 other studies used the total body potassium counting method (TBK) . Three studies used ultrasound (ULT), , 3 studies used peripheral quantitative computed tomography (pQCT), 1 study used air displacement plethysmography (ADP), and 1 study used MRI .…”