Cystic fibrosis, body composition, and health outcomes: a systematic review

Objectives: Patients with cystic fibrosis are characterized by an increased risk of nutrient malabsorption and inflammation, which may influence body composition. We examined the differences in body composition between patients with cystic fibrosis and healthy controls and how body composition differences may impact disease risk and mortality. Methods: Three different electronic databases (PubMed, Web of Science, and Embase) were used to find articles from inception until March 2017. The search strategy excluded articles that reported data on anthropometric measures only such as body weight, height, or waist circumference. Information on the characteristics of the study populations (e.g., age, sex, body mass index), type of study design, body composition methods, body compartments, and health outcomes was extracted. Results: Thirty-nine articles were included in the systematic review. The total number of patients with cystic fibrosis and controls that were included in these studies was 1839 and 2178, respectively. Only one study explored the association between body composition and risk of mortality whereas the majority of the studies examined the association between body composition and respiratory function (33%). Patients with cystic fibrosis had less fat-free mass and bone mineral density compared with the controls and fat-free mass was associated with decreased inspiratory muscle strength. Conclusions: Patients with cystic fibrosis may be at an increased risk of sarcopenia and osteopenia. The measurement of body composition could improve the assessment of nutritional status and reduce the risk for respiratory and metabolic complications in patients with cystic fibrosis. (C) 2018 Elsevier Inc. All rights reserved.