Context: Cystic fibrosis (CF) is a disease characterized by weight loss and chronic low-grade inflammation.

Objective: To assess changes in body composition and in the serum concentrations of adiponectin, a marker of negative energy balance and of insulin sensitivity, in adult patients with CF.

Design: Cross-sectional study.

Setting: Outpatient clinic of the University Hospital of Basel, Switzerland.

Participants: 24 stable adult CF patients and 24 healthy controls, matched for body mass index (BMI), age, sex and hormonal therapy in women.

Main Outcome Measures: Changes in body composition (assessed by dual x-ray absorptiometry) and in serum adiponectin levels.

Results: BMI, % fat mass (in percentage of body weight) and % lean body mass were similar in patients and controls, while central fat accumulation was increased [trunk to extremity fat ratio 1.2 (0.99-1.51) vs. 0.99 (0.81-1.25), P = 0.01] in patients with CF compared with controls. Decreased lean mass and increased highly sensitive C-reactive protein (hs-CRP) levels were independently associated with worse lung function in CF patients. Despite similar insulin resistance (HOMA model) and similar SHBG serum concentrations, the serum concentrations of adiponectin were higher in CF patients compared with controls, independent of other confounders (P = 0.01).

Conclusion: Central fat accumulation is increased in patients with CF. It is postulated that the energy deficit-induced increase in serum adiponectin could explain the preservation of insulin sensitivity in these patients in spite of the increase in central fat and in hs-CRP serum concentrations and could prevent a further deterioration of protein catabolism.