Obesity in cystic fibrosis

Abstract

The prevalence of obesity in patients with cystic fibrosis (CF) is increasing and around one-third of adults with CF are now overweight or obese. The causes of excess weight gain in CF are likely multifactorial, including: adherence to the high-fat legacy diet, reduced exercise tolerance, therapeutic advances, and general population trends. Increased weight has generally been considered favorable in CF, correlating with improved pulmonary function and survival. While the optimal BMI for overall health in CF is unknown, most studies demonstrate minimal improvement in pulmonary function when BMI exceeds 30 kg/m 2 . Dyslipidemia and cardiovascular disease are important co-morbidities of obesity in the general population, but are uncommon in CF. In people with CF, obesity is associated with hypertension and higher cholesterol levels. With longer life expectancy and rising obesity rates, there may be an increase in cardiovascular disease among people with CF in coming years. Overweight CF patients are more likely to be insulin resistant, taking on features of type 2 diabetes. Treating obesity in people with CF requires carefully weighing the metabolic risks of overnutrition with the impact of low or falling BMI on lung function. This article describes current knowledge on the epidemiology, causes, consequence, and treatment of obesity in people with CF.

Obstructive sleep apnea and nocturnal hypoxemia in adult patients with cystic fibrosis

“…Due to the diversity of studies and patient characteristics, it must be assumed that the prevalence of OSA is often underestimated, and further studies are needed to confirm our findings. This assumption is supported by the fact that the CF population is aging due to improved treatment options and obesity is an increasing problem [ 4 , 36 ].…”

“…Due to the diversity of studies and patient characteristics, it must be assumed that the prevalence of OSA is often underestimated, and further studies are needed to confirm our findings. This assumption is supported by the fact that the CF population is aging due to improved treatment options and obesity is an increasing problem [4,36]. Outside the field of CF, the co-existence of OSA and chronic obstructive airflow limitation (OSA-COPD overlap syndrome) has received increasing attention in recent years.…”

Telehealth and CFTR modulators: Accelerating innovative models of cystic fibrosis care

“…We have also observed an increase in the proportion and number of PwCF who are overweight or obese associated with the availability of CFTR modulators. Such patients may experience other health consequences associated with obesity (e.g., hypertension, cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnea) [15] . PwCF taking modulators have also experienced liver function abnormalities, increased anxiety and depression, and rashes.…”

Clinical and Genetic Characterisation of Cystic Fibrosis Patients in Latvia: A Twenty-Five-Year Experience

“…A study of longitudinal changes in nutrition using BMI values over a 10-year period has reported that underweight CF patients decreased from 20.6% to 11.1%, while overweight/obese CF patients increased from 7% to 18.4% [ 36 ]. Most of our patients were found to be in the normal weight group, where the BMI is between 19 and 25, which is very important for better lung function.…”