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Fat-Free Mass Depletion and Inflammation in Patients with Bronchiectasis

Published:November 20, 2012DOI:https://doi.org/10.1016/j.jand.2012.08.013

      Abstract

      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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      Biography

      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.

      Biography

      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.

      Biography

      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.

      Biography

      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.

      Biography

      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.

      Biography

      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.

      Biography

      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.

      Biography

      C. Olveira is a consultant, Pneumology Service, Carlos Haya University Hospital, Malaga, Spain.

      Biography

      I. Gaspar is a consultant, Pneumology Service, Costa del Sol Hospital, Marbella, Spain.