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Peripheral muscle function and body composition in people with cystic fibrosis on Elexacaftor/Tezacaftor/Ivacaftor: a cross-sectional, observational, single-centre study
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  • Lauren Clayton J,
  • Anthony Shepherd,
  • Jo Corbett,
  • Mathieu Gruet,
  • Gary Connett,
  • Mark Allenby,
  • Julian Legg,
  • Thomas Daniels,
  • Don Urquhart S,
  • Zoe Saynor L
Lauren Clayton J
University of Portsmouth Faculty of Science and Health
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Anthony Shepherd
University of Portsmouth Faculty of Science and Health
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Jo Corbett
University of Portsmouth Faculty of Science and Health
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Mathieu Gruet
Universite de Toulon
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Gary Connett
University Hospital Southampton NHS Foundation Trust
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Mark Allenby
University Hospital Southampton NHS Foundation Trust
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Julian Legg
University Hospital Southampton NHS Foundation Trust
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Thomas Daniels
University Hospital Southampton NHS Foundation Trust
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Don Urquhart S
Royal Hospital for Children and Young People
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Zoe Saynor L
University Hospital Southampton NHS Foundation Trust

Corresponding Author:[email protected]

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Abstract

Background: People with cystic fibrosis (pwCF) often have multifactorial peripheral muscle abnormalities attributed to, for example, malnutrition, steroid use, altered redox balance and, potentially, CF-specific intrinsic alterations. Malnutrition in CF now includes an increasing prevalence of overweight and obesity, particularly in those treated with CF transmembrane conductance regulator (CFTR) modulators. We aimed to characterise peripheral muscle function and body composition of pwCF on Elexacaftor/Tezacaftor/Ivacaftor (ETI) CFTR modulator treatment, compared to healthy controls. Methods: Fifteen pwCF on ETI, and 15 healthy age- and sex-matched controls (CON), underwent whole-body dual-energy X-ray absorptiometry scans, and a comprehensive evaluation of peripheral muscle function. These tests included quadriceps maximal isometric force measurement, an intermittent isometric quadriceps fatiguing protocol, handgrip strength dynamometry, squat jump height assessment, and a 1-minute sit-to-stand test. Results: No differences in quadriceps maximal isometric force (CON: 181.60 ± 92.90 Nm vs. CF: 146.15 ± 52.48 Nm, P = 0.21, d = 0.47), handgrip strength (CON: 34 ± 15 kg vs. CF: 31 ± 11 kg, P = 0.62, d = 0.18), peripheral muscle endurance, fatigue, or power were observed between the groups ( P>0.05). Moreover, no differences in whole-body, trunk or limb lean mass, fat-free mass, fat mass, or whole-body bone mineral density were evident ( P>0.05). Conclusion: Comparable peripheral muscle mass and function may be achievable in pwCF on ETI, especially those with good lung function. Research is needed to confirm these improvements in pwCF who have more severe lung disease, are less physically active, and have less optimal nutrition and exercise support.