Low fat-free mass and body mass index are associated with worse survival in patients with idiopathic pulmonary fibrosis (IPF)

Stéphane Jouneau (1) , Chloé Rousseau (2, 3) , Mathieu Lederlin (4, 2) , Mallorie Kerjouan (2) , Tiphaine Guy (5) , Laurent Sohier (6) , Alexandre Salé (2) , Stéphanie Guillot (2) , Laurent Vernhet (1) , Emmanuel Oger (7, 2) , Ronan Thibault (2, 8)

1 Irset - Institut de recherche en santé, environnement et travail
2 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
3 CIC - Centre d'Investigation Clinique [Rennes]
4 LTSI - Laboratoire Traitement du Signal et de l'Image
5 CH Vannes
6 CH Lorient - Centre Hospitalier de Lorient
7 REPERES - Recherche en Pharmaco-épidémiologie et Recours aux Soins
8 NuMeCan - Nutrition, Métabolismes et Cancer

Idiopathic pulmonary fibrosis (IPF) is a chronic fibrosing interstitial lung disease with a poor prognosis. The impact of malnutrition, especialy fat-free mass (FFM), on mortality is scarcely assessed in IPF patients. This study aimed at identifying factors associated with higher mortaliy in IPF. Nutritional status of 185 consecutive IPF patients from a referal Centre were prospectively evaluated by bioelectrical impedancemeter analysis (BIA) to measure FFM, body mass index (BMI), mid-arm circumference, triceps skinfold thickness, food intake analogue visual scale and biology. Malnutrition was defined as a FFM index (FFMI) <15 in women and <17 in men. Stepwise logistic regressions were performed to identify the factors associated with mortality. Malnutrition prevalence was 28% (52/185). IPF patients with low FFMI had higher mortality compared to patients with normal FFMI (p=0.015). In multivariable analyses, factors independently associated with mortality were active cancer, FFMI and BMI. IPF patients with malnutrition have higher mortality. FFMI and BMI are independently associated with mortality. Nutritional status assessment should be systematic in IPF patients. Further studies should aim at assessing wether a dedicated intervention to improve nutritional status would improve IPF patients’ prognosis. NB: We will add 6 more months of follow up for the presentation in September.

Mots clés: Idiopathic pulmonary fibrosis; Comorbidities; Systemic effect

Domaines: Ingénierie biomédicale

Stéphane Jouneau, Chloé Rousseau, Mathieu Lederlin, Mallorie Kerjouan, Tiphaine Guy, et al.. Low fat-free mass and body mass index are associated with worse survival in patients with idiopathic pulmonary fibrosis (IPF). European-Respiratory-Society (ERS) International Congress, Sep 2019, Madrid, Spain. pp.PA1337, ⟨10.1183/13993003.congress-2019.PA1337⟩. ⟨hal-02469275⟩