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Growth assessment of paediatric patients with CF comparing different auxologic indicators: A multicentre Italian
Vincenzina Lucidi1, Federico Alghisi, Valeria Raia
1Fondazione IRCCS, Ospedale Pediatrico Bambino Gesù, Rome, Italy.
Insights
Nutritional failure affects a minority of Italian cystic fibrosis (CF) patients, especially adolescents. Different growth indicators are crucial for identifying malnutrition risk and failure in children with CF.
Area of Science:
- Pediatric Endocrinology
- Nutritional Science
- Pulmonology
Background:
- Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs, with growth and nutritional status being key indicators of disease severity and treatment efficacy.
- Optimizing growth and nutritional status in pediatric CF patients is essential for long-term health outcomes.
Purpose of the Study:
- To evaluate the growth patterns and nutritional status of pediatric patients with cystic fibrosis in Italy.
- To identify the prevalence of nutritional failure and risk factors in this population.
Main Methods:
- A multicentre cross-sectional study involving 892 Italian patients with CF aged 0.1-18 years.
- Anthropometric data were assessed using Centers for Disease Control and Prevention 2000 reference data.
- Nutritional failure and risk were defined using specific percentiles for height-for-age, weight-for-length, and body mass index percentile (BMIp), with further analysis by age, sex, pancreatic insufficiency, meconium ileus, and lung function.
Main Results:
- 12.2% of patients exhibited height-for-age percentile <5th, 12.9% weight-for-length percentile <10th, and 20.9% BMIp <15th.
- Over half (54.4%) did not meet the target BMIp of ≥50th.
- Nutritional failure was most prevalent in adolescents (11-18 years), and growth parameters were significantly associated with pancreatic status and lung function.
Conclusions:
- Nutritional failure is a concern in a subset of Italian pediatric CF patients, particularly during adolescence.
- The study highlights the need for varied auxologic indicators to accurately identify children at risk of or with malnutrition.
- Monitoring growth and nutritional status is critical for managing CF in pediatric populations.
Objectives:
To evaluate growth in Italian patients with cystic fibrosis (CF).
Patients And Methods:
A multicentre cross-sectional study was carried out on patients with CF attending Italian reference centres. Anthropometric data were evaluated using the Centers for Disease Control and Prevention 2000 reference data. Nutritional failure was defined as height-for-age percentile (HAP) <5th (all patients); weight-for-length percentile (WLP) <10th (patients <2 years); body mass index percentile (BMIp) <15th (patients between 2 and 18 years). The risk of malnutrition (defined as HAP, WLP, and BMIp <25th) and the proportion of patients below the "BMIp goal" (BMIp > or =50th) were also evaluated. Nutritional status was evaluated in the whole population and in relation to age, sex, pancreatic insufficiency, meconium ileus, and lung function.
Results:
A total of 892 patients with CF (50.7% males, mean age 9.2 years, range 0.1-18 years) were enrolled. The proportion of children with HAP <5th, WLP<10th and BMIp<15th was 12.2%. 12.9%, 20.9%, respectively, and 54.4% did not fulfill the BMIp > or =50th goal. HAP <25th identified the highest proportion of children at risk of malnutrition, whereas BMIp <15th identified the highest proportion of children with nutritional failure. Whatever the criterion used to define malnutrition, the highest proportion of children with nutritional failure was found in adolescence (11-18 years). z scores for height, weight, and BMI were significantly associated with pancreatic status and lung function. Differences among centres for the auxologic parameters were not significant, except for BMIp.
Conclusions:
Nutritional failure is present in a minority of Italian patients with CF, particularly during adolescence. Different auxologic indicators should be used for identifying children at risk for or with actual malnutrition.
