S116
10. Gastroenterology/Nutrition
224 Nutritional status of patients with cystic fibrosis in Russia S. Krasovskiy1 , E. Amelina1 , E. Kondratyeva2 , A. Cherniak1 , A. Voronkova2 , V. Sherman2 , N. Kashirskaya2 , N. Kapranov2 , L. Shabalova2 , V. Nikonova2 , I. Asherova3 , E. Boitsova4 , V. Brisin5 , M. Khachiyan5 , V. Chikunov6 , N. Ilenkova6 , O. Golubtsova7 , J. Kondakova8 , L. Kozireva9 , T. Protasova10 , M. Skachkova11 , M. Rybalkina11 , T. Safonova10 , N. Merzlova12 , V. Shadrina12 , L. Nazarenko13 , I. Smirnova13 , D. Sergienko14 , T. Vasileva15 . 1 Institute of Pulmonology FMBA, Moscow, Russian Federation; 2 Federal State Budgetary Institution ‘Research Centre for Medical Genetics’, Cystic Fibrosis, Moscow, Russian Federation; 3 Regional CF Center, Yaroslavl, Russian Federation; 4 Regional CF Center, St. Petersburg, Russian Federation; 5 Regional CF Center, Krasnodar, Russian Federation; 6 Regional CF Center, Krasnoyarsk, Russian Federation; 7 Regional CF Center, Cheboksary, Russian Federation; 8 Regional CF Center, Novosibirsk, Russian Federation; 9 Regional CF Center, Yfa, Russian Federation; 10 Regional CF Center, Kemerovo, Russian Federation; 11 Regional CF Center, Orenburg, Russian Federation; 12 Regional CF Center, Perm, Russian Federation; 13 Regional CF Center, Tomsk, Russian Federation; 14 Regional CF Center, Astrakhan, Russian Federation; 15 Regional CF Center, Vladivostok, Russian Federation Objectives: To access the nutritional status of cystic fibrosis patients in Russia in the perspective of preventive measures’ development. Methods: Nutritional status was evaluated for 1026 patients with CF from 16 regions and the city of Novosibirsk. Nutritional status of CF patients was identified with the help of body mass index (BMI) by Quetelet [weight (kg)/height (m2 )]. Calculation of BMI percentile was performed with assistance of the World Health Organization’s program: WHO Anthro and Anthro plus. Results: BMI’s percentile’s median accounted for 28.0 (57.6) for boys and 24.0 (49.0) for girls in the group of children from 2 to 17 years old. BMI was recorded at the level of more than 50 percentile for girls under 3 years old and for boys under the age of 5. Decrease of BMI was observed during the period from 6 to 10 years (start of schooling). Significant decrease of BMI is registered from the beginning of puberty (around 11 years old). With regard to adults, BMI’s median was 18.5 kg/m2 (4.0 kg/m2 ) for males and 18.9 kg/m2 (3.7 kg/m2 ) for females. The dependence of respiratory function (FEV1) from nutritional status was determined. Survey has shown that out of 68 families with CF patients only 10% of children and teenagers receive special mixtures for enteral nutrition with 5% on a regular basis. Conclusion: Thus, it is recommended to start prevention of nutritional deficiency at the age of 4 for boys and at the age of 2 for girls. It is necessary to take preventive measures for all children before entering puberty. Doctors and patients should be better informed about possibility of enteral feeding.
Posters
226 Ultrasound and adipometer body fat measurement of cystic fibrosis (CF) children and adolescents P. Marostica1 , R. Souza1 , R. Baptista2 , J. Heinzmann Filho2 , L. Pinto2 , M. Epifanio2 , M. Donadio2 . 1 UFRGS, Porto Alegre, Brazil; 2 PUCRS, Porto Alegre, Brazil Objectives: To compare body fat between CF and healthy children and adolescents and to correlate ultrasound and adipometer skinfold measurements. Methods: CF children and adolescents, aged 6 to 18 years, followed at Hospital S˜ao Lucas da PUCRS, Brazil, outpatient clinics were included. Also, age and sex paired healthy individuals were included in the study. Participants underwent anthropometric measurements, followed by adipometer skinfold measurements and ultrasound subcutaneous fat tissue of upper arms, thighs and calves. Percentage fat estimation was done by summing upper arm and calf skinfolds. CF individuals underwent spirometry testing. Paired T-student and Pearson tests were used to compare groups and to check correlations between adipometer and ultrasound evaluations. Results: 35 CF and 35 healthy individuals were evaluated. The mean age was 12 years and 60% were males. There was no difference in demographic characteristics between groups, except for age corrected BMI, which was lower in CF individuals. (p = 0.031). CF children and adolescents had a slight pulmonary function compromise and a significative lower upper arm (p = 0.026) and thigh (p = 0.021) skinfold measurements. CF patients had lower fat body content, than healthy individuals (p = 0.047). Skinfold measurements and ultasound fat evaluation significantly correlated (p < 0.0001). Conclusion: CF children and adolescents have lower body fat when compared to paired healthy individuals. There was a good correlation between skinfold and ultrasound fat measurements.
225 Nutritional status of children with cystic fibrosis (CF) in Russia and neighboring territories
227 Differences in the nutritional status of adults with cystic fibrosis with and without the DF508 homozygous genotype
I. Sokolova1 , E. Roslavtseva2 , N. Zvonkova2 , O. Simonova1 , T. Borovik2 , T. Bushueva2 , A. Ignatova1 . 1 Scientific Center of Children’s Health, Pulmonology and Allergology, Moscow, Russian Federation; 2 Scientific Center of Children’s Health, Healhy and Sick Child Nutrition, Moscow, Russian Federation
D. Hopkins1 , T. Daniels2 , L. Marinio3 , E. Parsons1 . 1 Southampton University Hospitals NHS Trust, Biomedical Research Unit, Southampton, United Kingdom; 2 Southampton University Hospitals NHS Trust, Cystic Fibrosis Department, Southampton, United Kingdom; 3 Southampton University Hospitals NHS Trust, Nutrition and Dietetic Department, Southampton, United Kingdom
Objectives: Our previous abstract failed to elucidate if early diagnosis of CF by neonatal screening which had been introduced in Russia since 2006 had a positive influence on the nutritional status of CF children. We suppose that the higher portion of patients with low z-scores is a result of early diagnose but inadequate treatment in some distant Russian regions (Caucasus). The aim of the study was to determine the nutritional status of CF children in Russian regions versus some neighboring territories and Caucasus region. Methods: 61 children with CF from Moscow region (112 measurements), 64 children (141 measurements) from other Russian regions, 19 children from Ukraine, Kazakhstan and Moldova, receiving treatment in Moscow (41 measurements), and 25 children from Caucasus (40 measurements). Weight and height of CF children were recorded according to standard methods and expressed as standard deviation scores (z-score) and percentiles adjusted for age and gender using WHOAnthro- and WHOAnthroPlus programs. Results: Mann–Whitney test showed statistically significant differences in z-scores: weight/age (p < 0.001) and body length/age (p < 0.001) in Caucasus group versus Moscow region; weight/age (p < 0.001) and body length/age in Ukraine group (p < 0.001) versus Moscow region; body length/age in Moscow (p < 0.001) was better versus other Russian regions. Conclusion: Children with CF in Moscow and Russian regions have relatively good nutritional status compared with Caucasus region and Ukraine/Kazakhstan/ Moldavian patients with CF, which require better primary care in these regions.
Objectives: To characterise the nutritional status of people with Cystic Fibrosis (PWCF) attending an adult regional CF centre. Methods: Nutritional status (Body mass index (BMI)) was calculated at annual review on 118 PWCF in 2012 and 137 PWCF 2013. BMI (kg/m2 ) was classified into 5 categories: <17, 17–18.49, 18.5–24.99, 25–29.99 and 30. Genotype data was obtained from the medical records with PWCF and categorised as either ‘DF508 homozygous’ or ‘Other’ (containing DF508 heterozygous and less common genotypes). Comparisons were made between BMI status and genotype category. Results: Distribution of BMI status differed significantly between genotypes in both years (Fisher Exact: 2012, p = 0.004; 2013 p < 0.001). In 2013 median BMI In the DF508 homozygous group was 21.3 (Range: 14 to 30.8) compared to 23.6 (16.4 to 45.4) in the ‘Other’ group. Prevalence of underweight was higher within the DF508 homozygous population (21.7% vs. 7.4%), but similar levels of severe underweight status was observed in both genotype groups (2013: 5.8% vs. 5.9%). Overweight and obesity were higher within the ‘Other’ genotype group (2013: Overweight: 23.5% vs. 5.7%, Obese: 11.8% vs. 1.4%). Most patients with CF had a normal BMI (2013: DF508 homozygous: 73%, Other: 57%). Conclusion: BMI profiles were significantly different according to genotype category. Although most PWCF had a normal BMI, there were greater proportions of underweight amongst the DF508 homozygous population and more overweight within the ‘Other’ group. An awareness of the genetic profile of PWCF may enable modified dietary approaches to be made in order to optimise nutritional status.