Katharina Staufer1,2, Emina Halilbasic2, Peter Hillebrand2, Solveig Harm2, Stefan Schwarz3, Peter Jaksch3, Danijel Kivaranovic4, Walter Klepetko3, Michael Trauner2, Lili Kazemi-Shirazi2. 1. Department of Surgery, Division of Transplantation, Medical University of Vienna, Vienna, Austria. 2. Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria. 3. Department of Surgery, Division of Thoracic Surgery, Medical University of Vienna, Vienna, Austria. 4. Section for Medical Statistics, Centre for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
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/m2). Malnourished patients (BMI < 18.5 kg/m2; 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.
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/m2). Malnourished patients (BMI < 18.5 kg/m2; 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.
Entities:
Keywords:
Cystic fibrosis; bioelectrical impedance analysis; body mass index; lung transplantation; pulmonary function
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