Szentpetery Sylvia, Fernandez Gabriela S, Schechter Michael S, Jain Raksha, Flume Patrick A, Fink Aliza K
Medical University of South Carolina, Charleston, SC, USA.
Cystic Fibrosis Foundation, Bethesda, MD, USA.
J Cyst Fibros. 2022 Sep;21(5):777-783. doi: 10.1016/j.jcf.2022.03.010. Epub 2022 Apr 5.
Strong emphasis has been placed historically on increasing weight and improving nutritional status in cystic fibrosis patients. Due to correlation between nutritional indices (e.g. BMI) and lung function, CF Nutrition Guidelines have recommended BMI percentile goals at the 50th percentile or higher. Trends in increasing BMI across CF programs suggest significantly increasing proportions of overweight and obese status in recent years. We identify that between 2000 and 2019 there has been a relative decrease in underweight status by ∼40%, simultaneously with a > 300% increase in overweight status, and >400% increase in obesity. Patient specific factors associated with higher prevalence of obesity included age ≥46, living in a zip code where the median income was < $20,000, having at least one allele with a class IV or V mutation, a ppFEV >90 prescribed ivacaftor, and not prescribed pancreatic enzymes. Program specific factors were not identified.
历史上一直非常强调增加囊性纤维化患者的体重并改善其营养状况。由于营养指标(如体重指数)与肺功能之间存在相关性,囊性纤维化营养指南建议将体重指数百分位数目标设定在第50百分位数或更高。各囊性纤维化项目中体重指数上升的趋势表明,近年来超重和肥胖状态的比例显著增加。我们发现,在2000年至2019年期间,体重过轻状态相对下降了约40%,与此同时,超重状态增加了300%以上,肥胖状态增加了400%以上。与肥胖患病率较高相关的患者个体因素包括年龄≥46岁、居住在中位数收入低于20000美元的邮政编码地区、至少有一个IV类或V类突变等位基因、规定使用依伐卡托且ppFEV>90以及未使用胰酶。未发现项目特定因素。