Abstract
Malnutrition prevails in considerable proportions of children with Cystic Fibrosis (CF), and is often associated with adverse outcomes. For this, routine screening for malnutrition is pivotal. In the present cross-sectional study, we aimed to assess the risk for malnutrition in pediatric outpatients with CF. A total of 76 outpatients (44 girls, 11.9 ± 3.9 years old, 39.5% adolescents) were recruited and anthropometric, clinical, dietary and respiratory measures were collected. All outpatients were screened for malnutrition risk with a validated disease-specific instrument. Most children exhibited a low risk for malnutrition (78.9%), whereas none of the participants were characterized as having a high malnutrition risk. In the total sample, malnutrition risk was positively associated with age (r = 0.369, p = 0.001), and inversely related to the body mass index (r = −0.684, p < 0.001), height z-score (r = −0.264, p = 0.021), and forced expiratory volume (FEV1%, r = −0.616, p < 0.001). Those classified as having a low malnutrition risk were younger (p = 0.004), heavier (p < 0.001) and taller (p = 0.009) than their counterparts with a moderate risk. On the other hand, patients in the moderate risk group were more likely pubertal (p = 0.034), with a reduced mid-upper arm fat area (p = 0.011), and worse pulmonary function (p < 0.001). Interestingly, none of the children attaining ideal body weight were classified as having a moderate malnutrition. risk, whereas 37.5% of the patients allocated at the moderate risk group exhibited physiological lung function. In this cohort of outpatients with CF that were predominantly well-nourished and attained physiological lung function, malnutrition risk was identified only in small proportions of the sample. Our data support that patients that are older, pubertal, or have diminished fat mass are at greater risk for malnutrition.
Highlights
Cystic fibrosis (CF) is a chronic condition characterized by an increased risk of malnutrition.Poor nutritional intake due to increased energy loss and demands, inadequate caloric intake, Children 2020, 7, 269; doi:10.3390/children7120269 www.mdpi.com/journal/childrenChildren 2020, 7, 269 malabsorption and maldigestion, exacerbations of the disease, genetic susceptibility and the often underlying infections, increase the risk of malnutrition among patients with Cystic Fibrosis (CF) [1,2,3,4,5,6]
A variety of screening tools have been developed for pediatric patients, most of which can be used among hospitalized children, with the majority exhibiting good sensitivity and specificity [13]
A great proportion of participants had pancreatic insufficiency (86.8%), whereas none of the children were on enteral nutrition or exhibited low serum albumin levels
Summary
Cystic fibrosis (CF) is a chronic condition characterized by an increased risk of malnutrition.Poor nutritional intake due to increased energy loss and demands, inadequate caloric intake, Children 2020, 7, 269; doi:10.3390/children7120269 www.mdpi.com/journal/childrenChildren 2020, 7, 269 malabsorption and maldigestion, exacerbations of the disease, genetic susceptibility and the often underlying infections, increase the risk of malnutrition among patients with CF [1,2,3,4,5,6]. The latter appear to be more vulnerable to the development of malnutrition, due to their yet underdeveloped system, further increasing their nutrient demands and susceptibility to infection [5]. Severe cases of malnutrition might be more evident to the untrained eye, children at risk, or milder forms of malnutrition, often remain undiagnosed [12]. With this in mind, a variety of screening tools have been developed for pediatric patients, most of which can be used among hospitalized children, with the majority exhibiting good sensitivity and specificity [13]
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