Prevalence and factors associated with overweight and obesity in adults with cystic fibrosis: A single-center analysis

Background: The relation between malnutrition and pulmonary death in patients with cystic fibrosis (CF) has resulted in intensive nutritional intervention over the last few decades, leading to a significant decline in underweight and the emergence of overweight/obesity as a potential new problem. Methods: We performed a cross-sectional database analysis of 484 adults with CF seen at the University of Minnesota CF Center between January 2015-January 2017, to determine the prevalence and pulmonary/cardiovascular risk factors associated with overweight and obesity in this population. Results: Mean age was 35.2 ± 11.6 years. 5.2% were underweight (BMI<18.5 kg/m²), 62.6% normal weight (BMI ≥ 18.5–24.9 kg/m²), 25.6% overweight (BMI ≥ 25–29.9 kg/m²) and 6.6% obese (BMI ≥ 30 kg/m²). In the subgroup with severe genotypes, 25% had BMI ≥ 25 kg/m². In the entire cohort, overweight/obese were likely to be older (OR = 1.04, p < 0.0001) and to have a mild CFTR genotype (OR = 3.33, p = 0.0003) and modestly elevated triglyceride levels (OR = 1.008, p < 0.0001). The prevalence of hypertension was higher in overweight (25%) and obese (31%) than normal (17%) or underweight (16%), p = 0.01. Total cholesterol levels were higher in overweight/obese versus normal/underweight (144–147 vs 123–131 mg/dL, p = 0.04) as were LDL levels (70–71 vs 53–60 mg/dL, p = 0.02), but all were within the normal range. Percent predicted FEV1 was higher in overweight/obese (78–81%) versus underweight (59%) and normal (70%), p < 0.0001, and overweight/obese experienced significantly fewer acute pulmonary exacerbations. Conclusions: Overweight/obesity is common in adults with CF including those with severe genotypes. Lung function is better in the overweight/obese and lipid levels are within the normal range, albeit higher than in normal/underweight.