Secular changes in anthropometric data in cystic fibrosis patients

Area of Science:

• Pediatric Endocrinology
• Growth and Development
• Cystic Fibrosis Research

Background:

• Anthropometric data in cystic fibrosis (CF) patients are crucial for monitoring growth and clinical status.
• Understanding secular trends in these metrics can reveal impacts of evolving medical interventions.
• Previous studies have indicated improvements in CF patient outcomes over time.

Purpose of the Study:

• To investigate secular changes in anthropometric data, including height, BMI, and pubertal growth velocity, in CF patients from the 1960s to the 1990s.
• To assess if improvements in treatment have led to measurable changes in growth patterns over calendar time.
• To evaluate the influence of disease severity and survival bias on observed anthropometric trends.

Main Methods:

• Growth curves were developed for 270 CF patients using historical height and weight data.
• Analysis focused on secular changes in height, body mass index (BMI), peak height velocity (PHV) magnitude, and age at PHV.
• Statistical analysis compared data across different decades (1960s-1990s) and age groups.

Main Results:

• Significant increases in BMI were observed in 10- and 15-year-old boys and girls, and 5-year-old girls.
• The magnitude of pubertal peak height velocity (PHV) changed significantly over time, while the age at PHV remained constant.
• Height changes over time were not significant across most age groups, potentially due to selection bias favoring milder disease forms.

Conclusions:

• Increased BMI and altered PHV magnitude in CF patients suggest positive impacts of improved treatments on pubertal development and clinical status.
• These observed changes were substantial enough to mitigate the effects of selection bias related to survival of milder disease forms.
• The findings highlight the importance of long-term anthropometric monitoring in CF to assess treatment efficacy and population health trends.