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Growth and nutritional indexes in early life predict pulmonary function in cystic fibrosis
Michael W Konstan1, Steven M Butler, Mary Ellen B Wohl
1Department of Pediatrics, Rainbow Babies and Children's Hospital and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. mwk3@cwru.edu
Insights
Early growth and nutrition are strongly linked to better lung function in children with cystic fibrosis (CF). Maintaining adequate weight-for-age from age 3 to 6 is crucial for long-term pulmonary health.
Area of Science:
- Pediatric Pulmonology
- Pediatric Nutrition
- Cystic Fibrosis Research
Background:
- Cystic Fibrosis (CF) affects lung function and nutritional status in children.
- Early growth and nutritional status are potential indicators of long-term health outcomes in CF patients.
Purpose of the Study:
- To investigate the relationship between growth, nutritional status, and pulmonary function in young children with CF.
- To assess how early indicators of lung disease and nutritional status predict later pulmonary function.
Main Methods:
- A cohort of 931 children with CF was studied.
- Weight-for-age (WFA), height-for-age (HFA), and percent ideal body weight (%IBW) at age 3 were correlated with pulmonary function at age 6.
- Changes in WFA from age 3 to 6 were analyzed for their association with pulmonary function at age 6.
Main Results:
- Nutritional indicators (WFA, HFA, %IBW) at age 3 showed weak association with lung disease signs at age 3 but strong association with pulmonary function at age 6.
- Children with WFA below the 5th percentile at age 3 had significantly lower pulmonary function (FEV1) at age 6 compared to those above the 75th percentile.
- Sustained adequate WFA (above 10th percentile) from age 3 to 6 correlated with the highest pulmonary function at age 6.
- Presence of lung disease signs at age 3 was associated with reduced pulmonary function at age 6.
Conclusions:
- Growth and nutritional status are critical determinants of pulmonary function in children with CF.
- Early interventions targeting growth, nutrition, and lung disease in young CF patients may positively impact long-term pulmonary outcomes.
Objective:
To determine the relation of growth and nutritional status to pulmonary function in young children with cystic fibrosis (CF).
Study Design:
The relation of weight-for-age (WFA), height-for-age (HFA), percent ideal body weight (%IBW), and signs of lung disease at age 3 years with pulmonary function at age 6 years was assessed in 931 patients with CF. Associations of changes in WFA from age 3 to 6 on pulmonary function were also assessed.
Results:
WFA, HFA, and %IBW were poorly associated with lung disease at age 3 years, but all were strongly associated with pulmonary function at age 6 years. Those with WFA below the 5th percentile at age 3 had lower pulmonary function at age 6 compared with those above the 75th percentile (FEV(1): 86 +/- 20 [SD] versus 102 +/- 18 % predicted, respectively). Pulmonary function was highest in those whose WFA remained >10th percentile from age 3 to 6 (FEV(1): 100 +/- 19 % predicted) and lowest in those who remained <10th percentile (84 +/- 21 % predicted). Patients with signs and symptoms of lung disease at age 3 years had lower pulmonary function at age 6 years.
Conclusions:
Aggressive intervention early in life aimed at growth and nutrition and/or lung disease may affect pulmonary function.
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