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Longitudinal changes in growth parameters are correlated with changes in pulmonary function in children with cystic
Michelle L Peterson1, David R Jacobs, Carlos E Milla
1Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, USA.
Insights
Children with cystic fibrosis (CF) who maintain steady weight gain show improved lung function (FEV(1)). Consistent nutritional support is key for better pulmonary health and survival in pediatric CF patients.
Area of Science:
- Pediatric Pulmonology
- Nutritional Science
- Cystic Fibrosis Research
Background:
- Nutritional status significantly impacts pulmonary health and survival in pediatric cystic fibrosis (CF) patients.
- Understanding weight gain patterns is crucial for optimizing lung function trajectories in children with CF.
Purpose of the Study:
- To evaluate the relationship between weight gain patterns and longitudinal pulmonary function trends in children with CF.
- To test the hypothesis that continuous, consistent weight gain leads to better forced expiratory volume in 1 second (FEV(1)) compared to irregular patterns.
Main Methods:
- Prospective analysis of data from 319 children (aged 6-8) with CF followed over 2 years.
- Collected measurements included weight, height, and FEV(1).
- Utilized repeated measure regression and growth pattern analysis for data interpretation.
Main Results:
- Higher initial weight correlated with higher average FEV(1) at baseline.
- Each 1-kg weight gain during follow-up was associated with a 32-mL increase in FEV(1).
- Children with steady weight gain demonstrated greater FEV(1) increases than those with weight fluctuations.
Conclusions:
- Children with CF who maintain optimal weight and experience uninterrupted weight gain exhibit superior FEV(1) trajectories.
- Aggressive nutritional support to ensure consistent growth may enhance FEV(1), indicating improved lung health and potentially better survival rates.
Objective:
Nutritional status is associated with pulmonary health and survival in children with cystic fibrosis (CF). This study evaluated the weight gain pattern of children with CF in relation to the longitudinal trends of their pulmonary function. Our hypothesis was that children who experience continuous weight gain at a given rate will have better average forced expiratory volume in 1 second (FEV(1)) and change in FEV(1) than children who have weight gain patterns that deviate from this rate, even when total weight gain seems adequate.
Methods:
Prospectively collected data were examined in 319 children, aged 6 to 8, who were routinely followed at the Minnesota Cystic Fibrosis Center. One to 67 measurements of weight (kg), height (cm), and FEV(1) (mL) were taken per child during this 2-year period. The data were analyzed by repeated measure regression analysis and by growth pattern analysis.
Results:
At baseline, a 1-kg higher initial weight was associated with a 55-mL higher average FEV(1). During the follow-up period, a 1-kg gain in weight was associated with an increase in FEV(1) by 32 mL. Children who had a steady weight gain tended to experience greater increases in FEV(1) than children who experienced periodic losses in weight.
Conclusions:
We established that children who weigh more and who gain weight at an appropriate and uninterrupted rate have a better FEV(1) trajectory. Aggressive nutritional support to maintain growth in these children may therefore improve FEV(1), which can be taken as a surrogate for better lung health, and may ultimately lead to better survival.