SENSATION OF SMELL DOES NOT DETERMINE NUTRITIONAL-STATUS IN PATIENTS WITH CYSTIC-FIBROSIS

Poor nutritional status in patients with cystic fibrosis (CF) is assoc iated with increased mortality. Patients with CF often have a decrease d sensation of smell secondary to recurrent sinus infections or sinus surgery; in other CF populations, a decreased sensation of smell has b een associated with poor nutritional status. We hypothesized that a de creased sensation of smell would be associated with worse nutritional status in patients with CF. We studied 50 (26 F and 24 M) of 58 consec utive patients with CF (86%) aged 14-53 years (28 +/- 8; mean F SD) wh o attended the University of Washington Medical Center from June 1994 to March 1995 and who agreed to participate. Demographic information w as obtained, and nutritional status was assessed by ideal body weight, arm muscle area, arm fat area, pancreatic sufficiency, insulin-requir ing diabetes, vitamins A and E levels, albumin, iron, iron binding cap acity, ferritin, cholesterol, and zinc levels. Objective sensation of smell was examined (Sensonics, Philadelphia, PA), a sinus compacted to mogram (CT) was performed, and a questionnaire for prior sinus symptom s, sinus surgery, medications, and subjective sensation of smell was a dministered. Twenty-seven of 49 subjects (55%) had an objective decrea se in sensation of smell, 23/50 (46%) had had prior sinus surgery, 46/ 50 (92%) were pancreatic insufficient, and 8/50 (16%) were insulin-req uiring diabetics. Weight for height ranged from the 38th to 157th perc entile (100 +/- 18; mean +/- SD). Arm muscle area ranged from the <5th to the 75th percentile (25 +/- 23; mean +/- SD). Arm fat area ranged from the <5th to the 95th percentile (45 +/- 39; mean +/- SD). Sinus C T scans were abnormal in all patients (100%). Patients with anosmia we re more likely to have had sinus surgery, but their nutritional status was no different from that of patients with a normal sensation of sme ll. We conclude that decreased sensation of smell is common in patient s with CF, especially those with prior sinus surgery. Subjective sensa tion of smell and sinus CT scans were unreliable indicators of a decre ased objective sensation of smell. In this pilot study, no association was found between sensation of smell and nutritional status. (C) 1997 Wiley-Liss, Inc.