Prevalence and factors associated with overweight and obesity in adults with cystic fibrosis: A single-center analysis

Background: The relation between malnutrition and pulmonary death in patients with cystic fibrosis (CF) has resulted in intensive nutritional intervention over the last few decades, leading to a significant decline in underweight and the emergence of overweight/obesity as a potential new problem. Methods: We performed a cross-sectional database analysis of 484 adults with CF seen at the University of Minnesota CF Center between January 2015-January 2017, to determine the prevalence and pulmonary/cardiovascular risk factors associated with overweight and obesity in this population. Results: Mean age was 35.2 +/- 11.6 years. 5.2% were underweight (BMI<18.5 kg/m(2)), 62.6% normal weight (BMI >= 18.5-24.9 kg/m(2)), 25.6% overweight (BMI >= 25-29.9 kg/m(2)) and 6.6% obese (BMI >= 30 kg/m(2)). In the subgroup with severe genotypes, 25% had BMI >= 25 kg/m(2). In the entire cohort, overweight/obese were likely to be older (OR = 1.04, p < 0.0001) and to have a mild CFTR genotype (OR = 3.33, p = 0.0003) and modestly elevated triglyceride levels (OR = 1.008, p < 0.0001). The prevalence of hypertension was higher in overweight (25%) and obese (31%) than normal (17%) or underweight (16%), p = 0.01. Total cholesterol levels were higher in overweight/obese versus normal/underweight (144-147 vs 123-131 mg/dL, p = 0.04) as were LDL levels (70-71 vs 53-60 mg/dL, p = 0.02), but all were within the normal range. Percent predicted FEV1 was higher in overweight/obese (78-81%) versus underweight (59%) and normal (70%), p < 0.0001, and overweight/obese experienced significantly fewer acute pulmonary exacerbations. Conclusions: Overweight/obesity is common in adults with CF including those with severe genotypes. Lung function is better in the overweight/obese and lipid levels are within the normal range, albeit higher than in normal/underweight. (C) 2019 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.