Peculiarities of somatometric indices, formation of body composition and adherence to medical and dietary recommendations in Ukrainian pediatric patients with cystic fibrosis

Abstract

Patients with cystic fibrosis (CF) are prone to nutritional disorders due to malabsorption associated with this disease. Systematic assessment of nutritional status and organization of medical dietary therapy is an integral part of the management of patients with CF.

Aim - to determine the peculiarities of somatometric data, formation of body composition and eating behavior in Ukrainian pediatric patients with CF.

Materials and methods. 203 medical histories of children with CF since 2012 were retrospectively analyzed and 68 children were prospectively examined. Body weight (Wa) and height (Ha) for age, body mass index (BMI) were assessed. Body composition was determined according to the Slaughter-Lohmann equation based on the measurement of the thickness of 3 fat folds. The clinical course, indicators of spirometry and dynamometry were evaluated. The Eating attitude test 26 (EAT-26) was used to establish the reasons for violation of dietary recommendations. Generally accepted methods of medical statistics were used for data analysis.

Results. With age, the phenomenon of simultaneous lag in Wa and Ha increases in pediatric Ukrainian patients, isolated low body weight is found in a third of children. From the age of 10, a large stratum of children with excessive body weight is found, after the age of 15, every fifth patient is obese. No corresponding changes in BMI were noted. With age, there is an increase in the percentage of fat mass (%FM) in boys, although it is reduced in a third of boys under the age of 10, and another third has a deficiency. In girls in all age cohorts, a deficiency of %FM was noted. Absolute fat mass (AFM) increases, and absolute lean mass (ALM) decreases with age in boys with CF. Deficiency of AFM and %FM were noted, ALM was in the range of 25-50‰ in girls. A strong direct relationship between the index of AFM, %FM and ALM with the key indicators of spirometry and dynamometry was revealed. According to the EAT-26 questionnaire, children with CF feel the daily "burden of the disease" and relate to dietary recommendations through the prism of their own perception of the diagnosis.

Conclusions. The BMI, as a screening tool, appeared to be not a sufficiently sensitive indicator of the real presence of deviation in nutrition. Determining body composition according to the Slaughter-Lohmann equation is an informative tool for assessing the nutritional state of children with CF at the ambulatory follow-up. The detected changes in body composition in Ukrainian patients are characterized by a decrease in ALM and an increase in body fat mass and correlates with worse indicators of respiratory function. The use of the EAT-26 questionnaire allows timely to start correction of eating behavior.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interest was declared by the authors.