Fat-free mass depletion has been related to increased inflammatory activity and to increased morbidity and mortality in chronic respiratory diseases. The aims of our study were to determine the nutritional status and serum levels of adipocytokines and inflammatory cytokines in patients with bronchiectasis of any etiology and their relation with respiratory parameters. A cross-sectional study was designed that included patients aged >14 years with diagnostic criteria for bronchiectasis. Anthropometric parameters; a diet questionnaire; hand grip dynamometry; levels of leptin, adiponectin, interleukin-6 (IL-6), tumor necrosis factor-α, and ultrasensitive C-reactive protein; as well as respiratory parameters (ie, clinical, radiologic, and spirometric values) were assessed. Ninety-three clinically stable patients were recruited, 43 with cystic fibrosis, 31 with noncystic fibrosis bronchiectasis, and 19 with cystic fibrosis transmembrane conductance regulator-related bronchiectasis. Fat-free mass depletion was present in 31% of patients, with no differences according to the etiology of the bronchiectasis. Correlations were found between inflammatory cytokines (ie, IL-6) and exacerbations, bronchorrea, forced expiratory volume in 1 second, and Bhalla score. Patients with worse respiratory disease severity, malnutrition, and diabetes had significantly higher levels of IL-6. Adiponectin correlated significantly and positively with fat mass and fat mass index and negatively with fat-free mass, fat-free mass index, and hand dynamometry. Leptin correlated positively with body mass index, fat mass and fat mass index, and negatively with fat-free mass, fat-free mass index, and dynamometry. Patients with bronchiectasis present a high percentage of fat-free mass depletion, independent of the etiology of the disease. The levels of inflammatory cytokines (especially IL-6) may be useful markers of disease severity. Adiponectin levels were higher in patients with fat-free mass depletion.
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- Bronchiectasis.Chest. 2008; 134: 815-823
- Diagnosis and treatment of bronchiectasis.Arch Bronconeumol. 2008; 44: 629-640
- Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis.Chest. 2007; 132: 1565-1572
- Nutrition, cystic fibrosis and the digestive tract.Nutr Hosp. 2008; 23: 71-86
- Nutrition in patients with cystic fibrosis: A European Consensus.J Cyst Fibros. 2002; 1: 51-75
- Analysis of the factors related to mortality in patients with bronchiectasis.Respir Med. 2007; 101: 1390-1397
- C-reactive protein and body mass index predict outcome in end-stage respiratory failure.Chest. 2004; 126: 540-546
- Impact of nutritional status on body functioning in chronic obstructive pulmonary disease and how to intervene.Curr Opin Clin Nutr Metab Care. 2008; 11: 435-442
- Pulmonary function, body composition, and protein catabolism in adults with cystic fibrosis.Am J Respir and Crit Care Med. 2002; 165: 495-500
- The association between bronchiectasis, systemic inflammation, and tumor necrosis factor alpha.Arch Bronconeumol. 2008; 44: 8-14
- The diagnosis of cystic fibrosis: A consensus statement.J Pediatr. 1998; 132: 589-595
- Consensus on the use and interpretation of cystic fibrosis mutation analysis in clinical practice.J Cyst Fibros. 2008; 7: 179-196
- Fatty acid supplements improve respiratory, inflammatory and nutritional parameters in adults with cystic fibrosis.Arch Bronconeumol. 2010; 46: 70-77
- Cystic fibrosis: Scoring system with thin-section CT.Radiology. 1991; 179: 783-788
- Inhaled steroids improve quality of life in patients with steady-state bronchiectasis.Respir Med. 2006; 100: 1623-1632
- Anthropometric evaluation of nutritional status: Norms and criteria for denutrition and obesity.Med Clin (Barc). 1983; 80: 691-699
- Body fat assessed from total body density and its estimation from skinfold thickness: Measurements on 481 men and women aged from 16 to 72 years.Br J Nutr. 1974; 32: 77-97
- Body composition from fluid spaces and density: Analysis of methods.in: Brozeck A. Techiques for Measuring Body Composition. National Academy of Sciences, Washington, DC1961: 223-244
- Serum phospholipid fatty acid profile and dietary intake in an adult Mediterranean population with cystic fibrosis.Br J Nutr. 2006; 96: 343-349
- Markers for the validation of reported dietary intake in adults with cystic fibrosis.J Am Diet Assoc. 2009; 109: 1704-1711
- Height-normalized indices of the body's fat-free mass and fat mass: Potentially useful indicators of nutritional status.Am J Clin Nutr. 1990; 52: 953-959
- La Composición de Alimentos.Eudema SA, Madrid, Spain2010
- Tabla de Composición de Alimentos.5th ed. Instituto de Nutrición y Tecnología de los alimentos, Universidad de Granada, Granada, Spain2009
- Lipid, protein and calorie content of different atlantic and Mediterranean fish, selfish and mollusk commoly eaten in the south of Spain.Eur J Epidemiol. 1997; 13: 451-563
- Definition, diagnosis and classification of diabetes mellitus and its complications.Diabet Med. 1998; 15: 539-553
- Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.Diabetologia. 1985; 28: 412-419
- Incidence of type 2 diabetes in southern Spain (Pizarra Study).Eur J Clin Invest. 2008; 38: 126-133
- Diabetes Nutrition and Complications Trial: Trends in nutritional pattern between 1993 and 2000 and targets of diabetes treatment in a sample of Spanish people with diabetes.Diabetes Care. 2004; 27: 984-987
- A rational approach to nutritional assessment.Clin Nutr. 2008; 27: 706-716
- Use of body mass index percentile to identify fat-free mass depletion in children with cystic fibrosis.Clin Nutr. 2012; (Epub ahead of print)
- Body composition analysis in patients with cystic fibrosis.Arch Pediatr. 2011; 18: 370-375
- Assessment of nutritional status in adult patients with cystic fibrosis: Whole-body bioimpedance vs body mass index, skinfolds, and leg-to-leg bioimpedance.J Am Diet Assoc. 2005; 105: 549-555
- Fat-free mass depletion in cystic fibrosis: Associated with lung disease severity but poorly detected by body mass index.Nutrition. 2010; 26: 753-759
- Nutritional depletion in patients on long-term oxygen therapy and/or home mechanical ventilation.Eur Respir J. 2002; 20: 30-37
- Mucosal inflammation in idiopathic bronchiectasis: Cellular and molecular mechanisms.Eur Respir J. 2008; 31: 396-406
- Adult starvation and disease-related malnutrition: A proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee.Clin Nutr. 2010; 29: 151-153
- Plasma ghrelin and leptin in adult cystic fibrosis patients.J Cyst Fibros. 2008; 7: 398-402
- Adiponectin and inflammation: Consensus and controversy.J Allergy Clin Immunol. 2008; 121: 326-330
- Transcriptional and post-translational regulation of adiponectin.Biochem J. 2009; 425: 41-52
- Adiponectin and body composition in cystic fibrosis.J Cyst Fibros. 2008; 7: 244-251
- Body composition and adiponectin serum concentrations in adult patients with cystic fibrosis.J Clin Endocrinol Metab. 2006; 91: 1586-1590
- Normal total and high molecular weight adiponectin levels in adults with cystic fibrosis.J Cyst Fibros. 2011; 10: 483-486
- Normal adiponectin levels despite abnormal glucose tolerance (or diabetes) and inflammation in adult patients with cystic fibrosis.Diabetes Metab. 2007; 33: 213-219
G. Olveira is a consultant, CENTRE: Endocrinology and Nutrition Service (CIBER de Diabetes y enfermedades metabólicas asociadas of the Instituto de Salud Carlos III), Carlos Haya University Hospital, Malaga, Spain.
N. Colomo is a consultant, CENTRE: Endocrinology and Nutrition Service (CIBER de Diabetes y enfermedades metabólicas asociadas of the Instituto de Salud Carlos III), Carlos Haya University Hospital, Malaga, Spain.
N. Porras is a registered dietitian, CENTRE: Endocrinology and Nutrition Service (CIBER de Diabetes y enfermedades metabólicas asociadas of the Instituto de Salud Carlos III), Carlos Haya University Hospital, Malaga, Spain.
G. Martín-Núñez is a junior researcher, CENTRE: Endocrinology and Nutrition Service (CIBER de Diabetes y enfermedades metabólicas asociadas of the Instituto de Salud Carlos III), Carlos Haya University Hospital, Malaga, Spain.
E. Rubio is a junior researcher, CENTRE: Endocrinology and Nutrition Service (CIBER de Diabetes y enfermedades metabólicas asociadas of the Instituto de Salud Carlos III), Carlos Haya University Hospital, Malaga, Spain.
G. Rojo-Martínez is a senior researcher, CENTRE: Endocrinology and Nutrition Service (CIBER de Diabetes y enfermedades metabólicas asociadas of the Instituto de Salud Carlos III), Carlos Haya University Hospital, Malaga, Spain.
F. Soriguer is chief of service, CENTRE: Endocrinology and Nutrition Service (CIBER de Diabetes y enfermedades metabólicas asociadas of the Instituto de Salud Carlos III), Carlos Haya University Hospital, Malaga, Spain.
C. Olveira is a consultant, Pneumology Service, Carlos Haya University Hospital, Malaga, Spain.
I. Gaspar is a consultant, Pneumology Service, Costa del Sol Hospital, Marbella, Spain.
Published online: November 20, 2012
Accepted: August 6, 2012
FUNDING/SUPPORT This study was partly financed by grants from NEUMOSUR (Sociedad Andaluza de Neumología y Cirugía Torácica) and CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas).
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
© 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.