Nutritional Assessment in children with cystic fibrosis: The Role of Body Composition

Introduction Cystic fibrosis (CF) is a genetic disorder caused by CFTR gene mutations, leading to thick mucus that affects multiple organs, resulting in maldigestion, malabsorption, and poor appetite. These factors increase energy needs, causing undernutrition in CF patients. Body mass index (BMI) is commonly used but doesn't differentiate lean body mass (LBM) and bone mass. Bioelectrical impedance analysis (BIA) provides a more detailed assessment of body composition. This study aims to evaluate the nutritional status of children with CF by analyzing fat mass (FM) and fat-free mass (FFM) using BIA.Methods This study included CF patients aged 7 to 18 years from the Cystic Fibrosis Specialty Clinic at Akbar Children's Hospital in Mashhad, Iran. Excluded were patients with pulmonary exacerbation, severe diarrhea-induced dehydration, or those who did not give informed consent. Anthropometric measurements were assessed using the Tanita BC 418 BIA device.Results 47 patients (48.9% female, 51.1% male) with a mean age of 10.74 ± 2.99 years were evaluated. Significant positive correlations were found between FM and weight Z-score (r=0.512, p<0.001), BMI (r=0.430, p=0.003), and BMI Z-score (r=0.633, p<0.001). FFM was strongly correlated with age (r=0.814, p<0.001), height (r=0.931, p<0.001), and weight (r=0.977, p<0.001). The prevalence of low FM and FFM was 21.3% and 40.4%, respectively. Low FM was significantly associated with increased hospital admission (p=0.021, OR=15.62).Conclusion FM and FFM are strongly linked to growth and nutritional indicators in CF, with low FM correlating to more hospital admissions, highlighting the need for targeted nutritional interventions to improve outcomes.