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A prospective study of body composition changes in children with cystic fibrosis
N Stettler1, D A Kawachak, L L Boyle
1Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Pennsylvania 19104-4399, USA. nstettle@cceb.med.upenn.edu
Insights
Longitudinal growth in boys with cystic fibrosis (CF) is slower than in controls, impacting fat-free and fat mass development. This suggests that even with comprehensive care, CF boys may not achieve optimal growth.
Area of Science:
- Pediatrics
- Pediatric Nutrition
- Growth and Development
Background:
- Cross-sectional studies indicate improved growth and nutritional status in children with cystic fibrosis (CF).
- Longitudinal data on body composition changes in pediatric CF populations are limited.
- Comprehensive care aims to optimize growth and nutritional status in children with CF.
Purpose of the Study:
- To longitudinally assess changes in body composition in children with CF.
- To compare growth patterns and body composition development between children with CF and healthy controls.
- To evaluate the effectiveness of current CF care on long-term growth outcomes.
Main Methods:
- A four-year prospective study involving 25 children with CF and 26 controls (ages 5-10 years at baseline).
- Body composition assessed using skinfold thickness, total body water (deuterium dilution), and total body electrical conductivity (TOBEC).
- Comparison of statural growth, fat-free mass, and fat-mass increases between CF and control groups.
Main Results:
- Boys with CF exhibited slower statural growth compared to control boys.
- Fat-free mass and fat-mass accretion were significantly slower in boys with CF across multiple assessment methods.
- Observed growth differences were less pronounced in girls with CF compared to boys.
- Longitudinal data revealed suboptimal growth trajectories in boys with CF despite adherence to comprehensive care protocols.
Conclusions:
- Longitudinal monitoring reveals that boys with cystic fibrosis experience delayed growth and body composition development.
- Current comprehensive care may not fully optimize growth outcomes in male pediatric CF patients.
- Further research is needed to identify interventions to improve long-term growth in children with CF, particularly boys.
Abstract:
Recent cross-sectional studies of children with cystic fibrosis (CF) have shown an improvement in their growth with improved nutritional status, but there are only a few longitudinal studies in this population. A four-year prospective study was conducted in 25 children with CF and 26 controls, ages 5 to 10 years at baseline, to describe changes in body composition using three independent methods of assessment: skinfold thickness, total body water by deuterium dilution, and total body electrical conductivity (TOBEC). The statural growth of the boys with CF was slower than that of the control boys. Using different methods, the fat-free mass and fat-mass increases were shown to be slower in boys with CF than in controls. These differences were less significant in girls. Despite comprehensive care, the growth of boys with CF may still not be optimal, as observed longitudinally.