Preclinical atherosclerosis in cystic fibrosis: Two distinct presentations are related to pancreatic status

Jan Krzysztof Nowak; Andrzej Wykrętowicz; Edyta Mądry; Tomasz Krauze; Sławomira Drzymała-Czyż; Patrycja Krzyżanowska-Jankowska; Paulina Sobkowiak; Agata Schneider; Joanna Goździk-Spychalska; Szymon Kurek; Victoria Kononets; Nataliya Kashirskaya; Aleksandra Lisowska; Jarosław Walkowiak

doi:10.1016/j.jcf.2021.06.010

Preclinical atherosclerosis in cystic fibrosis: Two distinct presentations are related to pancreatic status

J Cyst Fibros. 2022 Jan;21(1):26-33. doi: 10.1016/j.jcf.2021.06.010. Epub 2021 Jul 10.

Authors

Affiliations

¹ Poznan University of Medical Sciences, Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan, Poland.
² Poznan University of Medical Sciences, Department of Cardiology-Intensive Therapy, Poznan, Poland.
³ Poznan University of Medical Sciences, Department of Physiology, Poznan, Poland.
⁴ Poznan University of Medical Sciences, Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan, Poland; Poznan University of Medical Sciences, Department of Bromatology, Poznan, Poland.
⁵ Poznan University of Medical Sciences, Department of Pediatric Pneumonology, Allergology and Clinical Immunology, Poznan, Poland.
⁶ Poznan University of Medical Sciences, Department of Pulmonology, Allergology and Respiratory Oncology, Poznan, Poland.
⁷ West Kazakhstan Marat Ospanov Medical University, Department of Natural Sciences Disciplines, Aktobe, Kazakhstan.
⁸ Research Centre for Medical Genetics, Department of Genetic Epidemiology, Cystic Fibrosis Group, Moscow, Russia.
⁹ Poznan University of Medical Sciences, Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan, Poland. Electronic address: jarwalk@ump.edu.pl.

PMID: 34253491
DOI: 10.1016/j.jcf.2021.06.010

Abstract

Background: Patients with cystic fibrosis (CF) are exposed to overlapping cardiovascular risk factors. We hypothesized that CF is characterized by increased arterial stiffness and greater intima-media thickness (IMT).

Methods: This cross-sectional study assessed the digital volume pulse arterial stiffness index (SI_DVP) using photopletysmography, measured intima-media complex thickness (IMT) at the common carotid artery, and obtained an extended set of clinical and atherosclerosis-related laboratory parameters.

Results: Fifty-five patients with moderate-to-severe CF (mean age 26.3±8.6 years, BMI 20.3±3.1 kg/m2, FEV1 62±26%) and 51 healthy controls (25.1±4.4 years, BMI 21.7±3.0 kg/m2) entered the study. SI_DVP was greater in pancreatic insufficient (PI), but not pancreatic sufficient (PS) CF patients compared with control (7.3±1.8 m/s vs 6.0±1.2 m/s; p=7.1 × 10^-5). IMT was increased in PS (but not PI) participants relative to control (552±69 µm vs 456±95 µm, p=0.0011). SI_DVP was also greater in PI than in PS patients (7.3±1.8 m/s vs 6.3±1.7 m/s, p=0.0232) and IMT was higher in PS compared with PI (552±69 µm vs 453±82 µm, p=0.0002). SI_DVP independently associated with age, PI, the lack of liver cirrhosis, and with Pseudomonas aeruginosa colonization. PS was the only independent correlate of IMT in CF.

Conclusions: PI patients are at risk of developing general arterial stiffness. PS may relate to carotid IMT thickening, which underscores the need for further study that could lead to reconsideration of dietary guidance in PS CF.

Keywords: Arterial stiffness; Atherosclerosis; Cystic fibrosis; Digital volume pulse; Intima-media; Lipids.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Atherosclerosis / etiology*
Carotid Intima-Media Thickness*
Cross-Sectional Studies
Cystic Fibrosis / complications*
Exocrine Pancreatic Insufficiency / complications*
Female
Humans
Male
Risk Factors
Vascular Stiffness*
Young Adult