Related Experiment Video
Updated: Jun 8, 2026
Design and Development of a Model to Study the Effect of Supplemental Oxygen on the Cystic Fibrosis Airway Microbiome
Published on: August 3, 2021
Body composition assessed by the 4-component model and association with lung function in 6-12-y-old children with
Jane E Williams1, Jonathan Ck Wells, Christian Benden
1Childhood Nutrition Research Centre and the Portex Unit, University College London Institute of Child Health, London, UK. jane.williams@ich.ucl.ac.uk
Insights
In cystic fibrosis (CF) patients, girls showed lower fat mass (FM) linked to poorer lung function, unlike boys. This highlights the need for sex-specific body composition analysis in CF care.
Area of Science:
- Pediatric Endocrinology
- Pulmonology
- Body Composition Analysis
Background:
- Malnutrition is a poor prognostic indicator in cystic fibrosis (CF).
- Previous body composition (BC) studies in children with CF utilized 2-component models (2CMs).
- The gold-standard 4-component model (4CM) offers more accurate BC evaluation but hasn't been applied to CF children.
Purpose of the Study:
- To measure BC using 4CM in 6-12-year-old children with CF.
- To compare BC findings in CF children with healthy controls and reference data.
- To correlate BC with lung spirometry (FEV₁) and compare 4CM with 2CM techniques.
Main Methods:
- Utilized the 4-component model (4CM) for body composition analysis.
- Included 100 clinically stable children with CF aged 6-12 years.
- Conducted spirometry to measure forced expired volume in 1 second (FEV₁).
Main Results:
- Girls with CF had significantly lower fat mass (FM) than healthy girls, even after adjustments.
- Boys with CF exhibited higher body mass index SD scores compared to healthy boys.
- Fat mass in girls with CF positively correlated with FEV₁ percentage predicted.
Conclusions:
- Boys with CF had normal body composition despite being shorter; girls had lower FM associated with poorer lung function.
- The findings suggest a need for greater attention to lower FM in girls with CF due to their worse prognosis.
- The reliability of 2-component model (2CM) techniques for body composition varied significantly by sex and health status.
Background:
Malnutrition is an indicator of a poor prognosis in patients with cystic fibrosis (CF). Previous body-composition (BC) studies in children with CF used 2-component models (2CMs) to assess fat mass (FM) and fat-free mass (FFM), but to our knowledge no study has used the gold-standard 4-component model (4CM), which allows for a more accurate evaluation of the nature of both elements.
Objective:
We measured BC by using the 4CM in 6-12-y-old children with CF to 1) compare findings with those of healthy, matched control children and reference data; 2) relate BC to lung spirometry [forced expired volume in 1 s (FEV₁)]; and 3) compare findings with those from more commonly used 2CM techniques.
Design:
One hundred clinically stable children with CF (57% girls) aged 6-12 y were measured by using the 4CM. Children with CF underwent spirometry (FEV₁).
Results:
Girls with CF had significantly less FM than did healthy girls, even after adjustment for height and pubertal status; boys with CF had higher body mass index SD scores than did healthy boys. FM in girls was positively associated with the FEV₁ percentage predicted. The 2CM FM was significantly different from the 4CM FM, with differences dependent on sex and condition, although most techniques identified a relation between FM and FEV₁ in girls.
Conclusions:
Although shorter than healthy children, boys with CF were heavier and had a BC within the normal range; however, girls with CF had lower FM than did healthy girls, and this was associated with poorer lung function. Given the worse prognosis in girls, this finding merits more attention. The reliability of 2CM techniques varied with sex and health status.
Related Concept Videos
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:23Cystic Fibrosis: Pathogenesis
CF is primarily caused by a genetic mutation in a chromosome 7 gene coding for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. The most common gene mutation leading to CF is the ΔF508 mutation, but...
01:24Cystic Fibrosis: Management
Sinus disease and chronic sinusitis...
01:27Physical Assessment of the Respiratory Tract II: Inspection
Chest Configuration
The chest configuration can...
01:25Pulmonary Function Tests
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features