Related Experiment Videos
Secular changes in anthropometric data in cystic fibrosis patients
E M Laursen1, C Koch, J H Petersen
1Department of Growth and Reproduction GR, State University Hospital, Rigshospitalet, Copenhagen, Denmark.
Insights
Secular changes in cystic fibrosis (CF) patients show increased BMI and altered peak height velocity, suggesting improved treatments. These changes helped overcome selection bias in milder disease forms.
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.
Abstract:
The aim of this study was to study the secular changes in anthropometric data over calendar time in patients with cystic fibrosis (CF). Growth curves were constructed for 270 patients based on height and weight registrations from the medical files. Height, body mass index (BMI), magnitude of pubertal peak height velocity (PHV) and age at PHV were analysed for possible secular changes from the 1960s to the 1990s. There was a significant change in height over calendar time in only 1 of 12 age groups. BMI showed a significant increase in 10- and 15-y-old boys and girls and in 5-y-old girls. The magnitude of PHV changed significantly over time, whereas age at PHV was constant. No significant changes in height and age at PHV over calendar time were observed; this was probably due to a selection bias since the oldest patients, who survived to be part of the present investigation, represented milder forms of the disease. The increase in BMI and change in magnitude of PHV over calendar time may reflect the improvement in treatment leading to a better survival and clinical status through puberty. The increase in BMI and change in magnitude of PHV were sufficient to overcome the selection bias from older patients with milder disease.