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Association between faecal pH and fat absorption in children with cystic fibrosis on a controlled diet and enzyme supplements dose

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Association between faecal pH and fat absorption in children with cystic fibrosis on a controlled diet and enzyme supplements dose

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dc.contributor.author Calvo-Lerma, Joaquim es_ES
dc.contributor.author Roca-Llorens, Maria es_ES
dc.contributor.author Boon, M. es_ES
dc.contributor.author Colombo, C. es_ES
dc.contributor.author de Koning, B. es_ES
dc.contributor.author FORNÉS-FERRER, V. es_ES
dc.contributor.author Masip, E. es_ES
dc.contributor.author Garriga, M. es_ES
dc.contributor.author Bulfamante, A. es_ES
dc.contributor.author Asensio-Grau, Andrea es_ES
dc.contributor.author Andrés Grau, Ana María es_ES
dc.contributor.author de Boeck, Kris es_ES
dc.contributor.author Hulst, J. es_ES
dc.contributor.author Ribes-Koninckx, C. es_ES
dc.date.accessioned 2021-04-17T03:33:14Z
dc.date.available 2021-04-17T03:33:14Z
dc.date.issued 2021-01 es_ES
dc.identifier.issn 0031-3998 es_ES
dc.identifier.uri http://hdl.handle.net/10251/165296
dc.description.abstract [EN] Background Despite treatment with pancreatic enzyme replacement therapy (PERT), patients with cystic fibrosis (CF) can still suffer from fat malabsorption. A cause could be low intestinal pH disabling PERT. The aim of this study was to assess the association between faecal pH (as intestinal pH surrogate) and coefficient of fat absorption (CFA). Additionally, faecal free fatty acids (FFAs) were quantified to determine the amount of digested, but unabsorbed fat. Methods In a 24-h pilot study, CF patients followed a standardised diet with fixed PERT doses, corresponding to theoretical optimal doses determined by an in vitro digestion model. Study variables were faecal pH, fat and FFA excretion, CFA and transit time. Linear mixed regression models were applied to explore associations. Results In 43 patients, median (1st, 3rd quartile) faecal pH and CFA were 6.1% (5.8, 6.4) and 90% (84, 94), and they were positively associated (p < 0.001). An inverse relationship was found between faecal pH and total fat excretion (p < 0.01), as well as total FFA (p = 0.048). Higher faecal pH was associated with longer intestinal transit time (p = 0.049) and the use of proton pump inhibitors (p = 0.009). Conclusions Although the clinical significance of faecal pH is not fully defined, its usefulness as a surrogate biomarker for intestinal pH should be further explored. Impact Faecal pH is a physiological parameter that may be related to intestinal pH and may provide important physiopathological information on CF-related pancreatic insufficiency. Faecal pH is correlated with fat absorption, and this may explain why pancreatic enzyme replacement therapy is not effective in all patients with malabsorption related to CF. Use of proton pump inhibitors is associated to higher values of faecal pH. Faecal pH could be used as a surrogate biomarker to routinely monitor the efficacy of pancreatic enzyme replacement therapy in clinical practice. Strategies to increase intestinal pH in children with cystic fibrosis should be targeted. es_ES
dc.description.sponsorship We acknowledge the support of the MyCyFAPP Project consortium. We especially thank the participation and the effort of the patients involved in the study and their families. This work was fully funded by the European Union and the Horizon 2020 Research and Innovation Framework Programme (PHC-26-2014 call Self management of health and disease: citizen engagement and mHealth) under grant number 643806. es_ES
dc.language Inglés es_ES
dc.publisher Nature Publishing Group es_ES
dc.relation.ispartof Pediatric Research es_ES
dc.rights Reserva de todos los derechos es_ES
dc.subject Proton-Pump inhibitor es_ES
dc.subject Pancreatic insufficiency es_ES
dc.subject Digestion es_ES
dc.subject Profiles es_ES
dc.subject Lipids es_ES
dc.subject Feces es_ES
dc.subject Acids es_ES
dc.subject.classification TECNOLOGIA DE ALIMENTOS es_ES
dc.title Association between faecal pH and fat absorption in children with cystic fibrosis on a controlled diet and enzyme supplements dose es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.1038/s41390-020-0860-3 es_ES
dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/643806/EU/Innovative approach for self-management and social welfare of Cystic Fibrosis patients in Europe: development, validation and implementation of a telematics tool./ es_ES
dc.rights.accessRights Abierto es_ES
dc.contributor.affiliation Universitat Politècnica de València. Instituto Universitario de Ingeniería de Alimentos para el Desarrollo - Institut Universitari d'Enginyeria d'Aliments per al Desenvolupament es_ES
dc.contributor.affiliation Universitat Politècnica de València. Departamento de Tecnología de Alimentos - Departament de Tecnologia d'Aliments es_ES
dc.description.bibliographicCitation Calvo-Lerma, J.; Roca-Llorens, M.; Boon, M.; Colombo, C.; De Koning, B.; Fornés-Ferrer, V.; Masip, E.... (2021). Association between faecal pH and fat absorption in children with cystic fibrosis on a controlled diet and enzyme supplements dose. Pediatric Research. 89(1):205-210. https://doi.org/10.1038/s41390-020-0860-3 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion https://doi.org/10.1038/s41390-020-0860-3 es_ES
dc.description.upvformatpinicio 205 es_ES
dc.description.upvformatpfin 210 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 89 es_ES
dc.description.issue 1 es_ES
dc.identifier.pmid 32247283 es_ES
dc.relation.pasarela S\407185 es_ES
dc.contributor.funder European Commission es_ES
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