Background: Historically, cystic fibrosis (CF) has been characterized by malnutrition and pulmonary decline. Recent advances in CF care, including genetic modulator therapies such as elexacaftor/tezacaftor/ivacaftor (ETI), have improved nutrition and lung function. An unexpected consequence has been the rise in overweight/obesity among patients with CF. Although Hispanics are at greater risk of developing overweight/obesity compared to non-Hispanic whites (NHW), ethnic differences regarding the prevalence in CF are unknown.
Methods: To determine the prevalence of overweight and obesity in Hispanics and NHW, we performed a cross-sectional retrospective chart review of patients 2-18 years of age at our CF center. Demographics, socioeconomic status, CF-related variables, and cardiometabolic risk factors were extracted from the medical record. Overweight/obesity data were analyzed by logistic regression using the following independent variables: ethnicity, age, sex, income, ETI therapy, supplemental feeding, and pancreatic sufficiency.
Results: Sixty-eight children with CF (46% Hispanic, 51% female, ages 11 ± 4 years, 74% on ETI) were assessed. Twenty-four (35%) children were overweight/obese (11 Hispanic). No ethnic differences were apparent. When analyzed univariably, overweight/obesity was associated with less supplemental feedings (odds ratio [OR] 0.19, 95% CI 0.063 to 0.58, P = 0.003) and more pancreatic sufficiency (OR 10.50, 95% CI 2.01 to 54.84, P = 0.005). Multivariable analysis revealed overweight/obesity was only associated with decreased odds of supplemental feedings (OR 0.098, 95% CI 0.018 to 0.54, P = 0.008).
Conclusion: In our ethnically diverse CF center, overweight/obesity is prevalent in 1 in 3 children. Prospective, longitudinal multicenter studies performed in diverse CF populations are warranted to identify factors associated with the development of overweight/obesity and to inform management and obesity-related screening for children with CF.
R. Pillai: None. W. Koek: None. M.S. Rayas: None.
