242 Evaluation of the size and contraction of the gallbladder by ultrasound in cystic fibrosis patients with and without pancreatic insufficiency

Abstract

Objectives: Previous studies suggest a cystic fibrosis (CF) enteropathy. It can be hypothesized that this enteropathy contributes to the characterizing poor nutritional status, gradual decline in pulmonary function and subsequent mortality in these patients. This study aimed to investigate enterocyte damage and intestinal inflammation in CF, and its relation to pulmonary function. Methods: Serum intestinal fatty acid binding protein (I-FABP), a circulating marker for enterocyte damage, was analysed in a cohort of 72 CF patients and 107 controls. Data regarding faecal calprotectin − a marker for intestinal inflammation, pulmonary function, and comorbidities were extracted from the medical charts. Conclusion: I-FABP levels were significantly elevated in CF patients as compared to controls (502 pg/ml [281–774] and 288 pg/ml [147–349], p< 0.001). Serum I-FABP was negatively correlated with forced expiratory volume (FEV1) in children (rp −0.589, p< 0.05, n = 15). Calprotectin levels were elevated in 93% of CF patients, and correlated positively with age (rs 0.350, p< 0.05, n = 20) and negatively with FEV1 in adults (rs −0.440, p< 0.01), even after correction for age. Patients with CF-related diabetes (CFRD), exocrine pancreatic insufficiency (EPI) and patients using protonpompinhibitors (PPIs), showed elevated calprotectin levels. In this study, for the first time, enterocyte damage in CF is demonstrated using I-FABP as a marker. Presence of intestinal inflammation in CF patients was confirmed and now shown to be worse in EPI, CFRD and PPI use. Moreover, the data of this study suggest a relation between intestinal damage and inflammation and pulmonary function.