T. Moudiou, A. Galli-Tsinopoulou, S. Nousia-Arvanitakis.
4th Department of Pediatrics, Aristotle University, Thessaloniki, Greece
The aim of this study was to prove the hypothesis that exocrine pancreatic function determines resting energy expenditure (REE) in Cystic Fibrosis (CF). Thirty-eight CF individuals (9 to 34, 19.98±1.0 yrs) were divided in two groups: 32 patients, who had exocrine pancreatic insuf.ciency (PI) (Group A) and 6 patients with pancreatic suf.ciency (PS) (Group B). A sub-group C included 19 PI patients whose predicted FEV1% was comparable to that of Group B. Indirect calorimetry and Scho.eld equations were applied to calculate predicted REE. Measured REE was expressed as % of the predicted values. BMI and BMI z-scores were related to REE.
The results were expressed as mean ± standard error. Group A had increased REE% (113±3.81%) as opposed to group B whose REE% was similar to the predicted values (98.9±3.81%) (p = 0.022). Sub-group C also had increased REE% (110.82±2.72%), which was comparable to that of group A and significantly different from group B (p = 0.035). Mean FEV1% was 74.53±4.9%, 86.33±10.1% 92.1±4.55%, mean BMI was 19.7±0.5, 25.6±2.06 and 19.13±0.66 and BMI z-scores were -0.72±0.2, 0.75±0.51 and -0.62±0.26, in Group A, B and C, respectively. Significant correlation was demonstrated between REE% and BMI z-scores in-group B (r = -0.83, p = 0.038) but not in groups A and C.
Conclusions: Clinically stable CF patients with similar pulmonary function exhibited increased REE% only in the presence of exocrine pancreatic insufficiency. Pancreatic sufficiency was related to normal REE%. Furthermore, REE% strongly correlated with BMI z-scores in pancreatic sufficiency but not in pancreatic insufficiency. These findings support the hypothesis that exocrine pancreatic rather than pulmonary function may determine nutritional status and REE% in CF patients.