Effect of exocrine pancreatic function on resting energy expenditure in cystic fibrosis.
OBJECTIVE
To prove the hypothesis that exocrine pancreatic function determines resting energy expenditure (REE) in cystic fibrosis (CF).


METHODS
Thirty-eight CF individuals, 9-34 (19.98 +/- 1.0) years, were divided into three groups: Six pancreatic sufficient patients (PS; group A), 21 pancreatic insufficient patients (PI), whose pulmonary function was comparable to that of group A (group B1) and 11 PI patients, whose pulmonary function was significantly worse than that of group A (group B2). REE was estimated by indirect calorimetry. Predicted REE was based on Schofield equations. Measured REE was expressed as % of the predicted. BMI, BMI z-scores, serum albumin, cholesterol and triglycerides levels were related to REE. Results were expressed as mean +/- standard error.


RESULTS
Groups B1 and B2 had significantly higher REE% (111.7 +/- 2.75% and 119.94 +/- 3.8, respectively) as opposed to group A (98.9 +/- 3.81%; p = 0.022 and 0.035, respectively) whose REE% was similar to that predicted. REE% between group B1 and B2 was not statistically significant. In groups A, B1 and B, mean FEV1% was 86.33 +/- 10.1%, 90.24 +/- 4.39%, 44.54 +/- 3.47%, respectively, mean BMI was 25.6 +/- 2.06, 19.48 +/- 0.64 and 20.09 +/- 8.8, respectively, BMI z-scores were 0.75 +/- 0.51, -0.52 +/- 0.24 and -1.07 +/- 0.37, respectively. Significant correlation was demonstrated between REE%, BMI z-scores and cholesterol levels in group A.


CONCLUSIONS
Clinically stable CF patients, who had comparable pulmonary function, exhibited increased REE% only in the presence of exocrine pancreatic insufficiency. REE% strongly correlated with BMI z-scores in pancreatic sufficiency. These findings support the hypothesis that pancreatic rather than pulmonary function may determine nutritional status as well as REE in CF.
Moudiou
T
T
Second Department of Pediatrics, Aristotle University of Thessaloniki, Greece. tmod@med.auth.gr
Galli-Tsinopoulou
A
A
Nousia-Arvanitakis
S
S
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002151:Calorimetry; D015897:Comorbidity; D003550:Cystic Fibrosis / Q000503:physiopathology*; D004734:Energy Metabolism / Q000502:physiology*; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009752:Nutritional Status; D046790:Pancreas, Exocrine / Q000502:physiology / Q000503:physiopathology*; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000503:physiopathology; D012129:Respiratory Function Tests; D012146:Rest / Q000502:physiology*