Objective: Growth of patients with cystic fibrosis (CF) and meconium ileus is frequently compromised. The aim of this prospective study was to evaluate body composition in this particular group of patients. We hypothesized that history of meconium ileus could predict suboptimal growth, bone, muscle and fat mass, irrespective of other prognostic factors for CF.
Methods: CF subjects were investigated over a 3-year period. Their medical records were reviewed and the following data were collected: forced expiratory volume in 1 sec (% predicted value, FEV1%), 25(OH) D levels, CF mutation, presence of diabetes mellitus and pancreatic insufficiency, systemic steroid courses/year, fracture history, dietary calcium intake and exercise. All patients were examined and their weight, height and BMI were recorded and expressed as z-scores. Then, dual-energy x-ray absorptiometry (DXA) was performed, at the lumbar spine and total body (less head, TBLH). Bone mineral density (BMD), lean tissue mass (LTM) and fat mass (FM) were measured and z-scores were calculated. Finally, CF patients with a history of meconium ileus were compared to participants with no such history.
Results: A total of 101 patients with CF and pancreatic insufficiency were assessed (mean age 13.9±2.9 years, 79 females, 81 adolescents). Of all patients, 19 had a history of meconium ileus; they were significantly different from the other patients in terms of BMI, BMD TBLH, LTM and FM z-scores, as well as FEV1%.
History of meconium ileus was associated with low fat mass (OR=5.38, P=0.002); the relation with BMD TBLH z-score and LTM z-score was not statistically significant, with a marginal P-value of 0.051 and 0.056 respectively. The significant association between a history of meconium ileus and low fat mass persisted after adjustments for age, CF genotype, degree of lower airway obstruction and need for systemic steroids.
Conclusion: History of meconium ileus in CF patients could be a predisposing factor to low BMI and fat mass, whereas cortical bone and muscle mass are only marginally affected. Patients with this profile should be targeted towards prompt nutritional interventions and regular surveillance of their body composition profile.
Disclosure: The authors declared no competing interests.
27 - 30 Jun 2015