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United European Gastroenterol J. 2018 Aug;6(7):1049-1055. doi: 10.1177/2050640618778381. Epub 2018 May 17.

Impact of nutritional status on pulmonary function after lung transplantation for cystic fibrosis.

Author information

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.

KEYWORDS:

Cystic fibrosis; bioelectrical impedance analysis; body mass index; lung transplantation; pulmonary function

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