Nutritional and Morphofunctional Assessment in a Cohort of Adults Living with Cystic Fibrosis with or Without Pancreatic Exocrine and/or Endocrine Involvement

TL;DR

This study assesses the nutritional and physical health of adults with cystic fibrosis, finding that nearly half are malnourished, especially males with exocrine pancreatic issues.

Contribution

The study identifies gender-specific differences in malnutrition prevalence among cystic fibrosis patients with exocrine pancreatic insufficiency.

Findings

47.5% of participants were malnourished according to GLIM criteria.

Males with exocrine pancreatic insufficiency had significantly higher undernourishment rates than those without.

Endocrine pancreatic involvement did not impact morphofunctional assessment outcomes.

Abstract

Objectives: To describe the results of nutritional and morphofunctional assessment in a cohort of adults with cystic fibrosis; to evaluate differences in nutritional status between patients with and without exocrine and/or endocrine pancreatic involvement. Methods: Cross-sectional study: A cohort of adults with cystic fibrosis evaluated in a multidisciplinary unit was analyzed. Pancreatic status was examined, and malnutrition was diagnosed according to GLIM criteria. Morphofunctional assessment consisted of nutritional ultrasound, bioelectrical impedance, handgrip dynamometry, and anthropometry. Qualitative variables are expressed as n (%), quantitative variables as median (IQR). For group comparisons, Fisher’s exact test was used for qualitative variables and the non-parametric median comparison test for quantitative variables. Results: n = 101 participants were recruited, of whom 44 (43.6%) were women. Median age was 33 (25–40.5) years. A total of 64 participants (63.4%) had exocrine pancreatic insufficiency (EPI), 44 (43.6%) had endocrine pancreatic insufficiency, and 28 (27.7%) had cystic fibrosis-related diabetes (CFRD). Median BMI was 23.4 (20.1–24.89) kg/m2. A total of 48 patients (47.5%) were malnourished. Males with EPI had a higher prevalence of undernourishment than those without (56.4% vs. 16.7%, p = 0.005), but not women. CFRD patients displayed no differences in morphofunctional assessment. Conclusions: Almost half the sample was undernourished using GLIM criteria. Males with exocrine pancreatic insufficiency had worse nutritional status. Endocrine pancreatic involvement did not affect nutritional status.