Racha T Khalaf1,2, Deanna Green3, Ernest K Amankwah4, Jacquelin Peck5, Vanessa Carr6,7, Neil A Goldenberg8, Michael Wilsey9. 1. Digestive Health Institute & Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA. 2. Department of Medical Education, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA. 3. Department of Pulmonology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA. 4. Health Informatics, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA. 5. Department of Anesthesiology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA. 6. Department of Nutrition Services, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA. 7. Medical Nutrition, Kate Farms, Inc, Santa Barbara, California, USA. 8. Department of Hematology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA. 9. Department of Gastroenterology, Hepatology and Nutrition, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA.
Abstract
BACKGROUND: Improving nutrition status of patients with cystic fibrosis (CF) has a positive effect on pulmonary function. METHODS: We conducted a retrospective case-control study evaluating the effect of percutaneous endoscopic gastrostomy (PEG) placement on body mass index (BMI) and forced expiratory volume in 1 second percent predicted (FEV1 ) between matched subjects with CF who received PEG (n = 20) and controls who did not (n = 40). RESULTS: We observed that after adjusting for mutation class and baseline BMI, BMI percentile increased per month for those with PEG (0.51, 95% confidence interval (CI) = -0.05-1.08, P = .08), but decreased for those without PEG (-0.03, 95% CI = -0.33-0.28, P = .86); however, the difference (0.54; 95% CI = -0.10-1.18, P = .10) was not statistically significant. FEV1 change with time showed a decrease for patients with PEG (-0.04; 95% CI = -0.30-0.22, P = .74) and those without PEG (-.22; 95% CI = -0.45-0.01, P = .06). Although the decrease for those without PEG was higher than those with PEG, the difference between the groups was not statistically significant (0.18; 95% CI = -0.17-0.52, P = .32) CONCLUSION: Lung function trajectory showed a trend towards preservation among patients with CF who receive PEG despite lack of significant difference in BMI. There may be a favorable effect of PEG on lung function independent of changes in BMI.
BACKGROUND: Improving nutrition status of patients with cystic fibrosis (CF) has a positive effect on pulmonary function. METHODS: We conducted a retrospective case-control study evaluating the effect of percutaneous endoscopic gastrostomy (PEG) placement on body mass index (BMI) and forced expiratory volume in 1 second percent predicted (FEV1 ) between matched subjects with CF who received PEG (n = 20) and controls who did not (n = 40). RESULTS: We observed that after adjusting for mutation class and baseline BMI, BMI percentile increased per month for those with PEG (0.51, 95% confidence interval (CI) = -0.05-1.08, P = .08), but decreased for those without PEG (-0.03, 95% CI = -0.33-0.28, P = .86); however, the difference (0.54; 95% CI = -0.10-1.18, P = .10) was not statistically significant. FEV1 change with time showed a decrease for patients with PEG (-0.04; 95% CI = -0.30-0.22, P = .74) and those without PEG (-.22; 95% CI = -0.45-0.01, P = .06). Although the decrease for those without PEG was higher than those with PEG, the difference between the groups was not statistically significant (0.18; 95% CI = -0.17-0.52, P = .32) CONCLUSION: Lung function trajectory showed a trend towards preservation among patients with CF who receive PEG despite lack of significant difference in BMI. There may be a favorable effect of PEG on lung function independent of changes in BMI.
Authors: Jacquelin Peck; Anh Thy H Nguyen; Aditi Dey; Ernest K Amankwah; Mohamed Rehman; Michael Wilsey Journal: Pediatr Gastroenterol Hepatol Nutr Date: 2021-01-08