Impact of nutritional status on pulmonary function after lung transplantation for cystic fibrosis. Issue 7 (August 2018)

• Record Type: Journal Article
• Authors: Staufer, Katharina; Halilbasic, Emina; Hillebrand, Peter; Harm, Solveig; Schwarz, Stefan; Jaksch, Peter; Kivaranovic, Danijel; Klepetko, Walter; Trauner, Michael; Kazemi-Shirazi, Lili
• Is Part Of: United European Gastroenterology journal. Volume 6:Issue 7(2018)
• Page Start: 1049
• Page End: 1055
• Publication Date: 2018-08
• Subjects: Cystic fibrosis -- lung transplantation -- bioelectrical impedance analysis -- body mass index -- pulmonary function; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640618778381
• Languages: English
• ISSNs: 2050-6406

Abstract

Background: Nutritional status is an important prognostic factor in patients with cystic fibrosis (CF) prior to lung transplantation. Objective: To investigate the impact of nutritional status on pulmonary function in CF transplant recipients. Methods: Adult double lung transplanted CF patients were consecutively included. The predictive value of nutritional status on lung function – measured by spirometry – was longitudinally assessed by body composition serially evaluated by a three-compartment model bioelectrical impedance analysis (BIA) in comparison to body mass index (BMI). Results: Overall, 147 spirometries and 147 BIAs were performed in 58 patients (59% female, median age: 30.1 years, median BMI: 19.6 kg/m 2 ). Malnourished patients (BMI < 18.5 kg/m 2 ; 27.6%) had a significantly reduced lung function compared to normal/overweight patients (forced expiratory volume in 1 second in percent (FEV1%pred), 57% vs 77%; p = 0.024). BMI, as well as the BIA parameters phase angle, total body water, fat free mass, body cell mass (BCM) and extracellular mass (ECM)/BCM ratio, were univariate predictors of FEV1%pred. When included in a linear mixed model, ECM/BCM ratio remained the only significant predictor of lung function ( p = 0.012). Conclusion: Nutritional status assessed by BIA predicted lung function in CF transplant recipients. Serial BIA measurements to monitor patients' nutritional status might help to improve or maintain lung function.