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Body composition and lung function in children with cystic fibrosis and meconium ileus
Artemis Doulgeraki1, Argyri Petrocheilou2, Glykeria Petrocheilou1
1Department of Bone and Mineral Metabolism, Institute of Child Health, Aghia Sophia Children's Hospital, Athens, Greece.
Insights
Children with cystic fibrosis (CF) and a history of meconium ileus (MI) show lower bone mineral density, fat mass, and lung function. This indicates a long-term impact of neonatal MI on CF patients' body composition and respiratory health.
Area of Science:
- Pediatric Pulmonology
- Cystic Fibrosis Research
- Body Composition Analysis
Background:
- Neonatal meconium ileus (MI) is a common complication in cystic fibrosis (CF).
- Previous studies suggest a link between MI and poorer growth and lung function in CF patients.
- The long-term effects of MI on body composition and lung function in pediatric CF populations require further investigation.
Purpose of the Study:
- To investigate the association between a history of meconium ileus (MI) and later body composition and lung function in children and adolescents with cystic fibrosis (CF).
- To explore the relationship between body composition metrics (bone mineral density, lean tissue mass, fat mass) and lung function (FEV1) in this cohort.
Main Methods:
- Retrospective analysis of data from 101 children and adolescents with CF undergoing routine spirometry and DXA scans.
- General linear models were used to assess associations between MI history and body composition outcomes (TBLH aBMD, LTM, FM).
- Exploration of relationships between body composition and FEV1.
Main Results:
- A history of MI was negatively associated with FEV1 (P=0.04), total body less head areal bone mineral density (TBLH aBMD) (P=0.03), and fat mass (FM) (P<0.01).
- No significant association was found between MI history and lean tissue mass (LTM) (P=0.07).
- Lung function (FEV1) was positively associated with TBLH aBMD (P<0.01) and LTM (P=0.02).
Conclusions:
- Children and adolescents with CF and a history of MI exhibit significantly lower bone mineral density, fat mass, and lung function compared to those without MI history.
- These findings highlight the persistent impact of neonatal meconium ileus on the overall health status of individuals with cystic fibrosis.
- Suboptimal bone mineral density coexists with reduced lung function in pediatric CF patients with a history of MI.
Abstract:
The aim of this study was to explore whether history of meconium ileus (MI) at birth in children and adolescents with cystic fibrosis (CF) adversely affects body composition and lung function in later life. Data of children and adolescents with CF who underwent spirometry and DXA as part of their routine care were analyzed. Associations between MI (explanatory variable) and areal bone mineral density (total body less head-TBLH aBMD), lean tissue mass (LTM), and fat mass (FM) (outcomes) were assessed using general linear models. Potential relationships of TBLH aBMD, LTM, and FM with FEV1 (additional outcome) were also explored. One hundred and one subjects with CF (mean age 14 ± 3 years) were included, 19 (18.8%) of whom had history of MI. Negative associations were demonstrated between history of MI and FEV1 (P = 0.04), TBLH aBMD (P = 0.03), and FM (P < 0.01) but not between history of MI and LTM (P = 0.07) after adjustment for other variables. Lung function was positively associated with TBLH aBMD (P < 0.01) and LTM (P = 0.02) but not with FM (P = 0.20).
Conclusion:
Among children and adolescents with CF, those with history of MI have lower bone mineral density, FM, and lung function. What is Known: • Among children and adolescents with cystic fibrosis, those with history of meconium ileus in the neonatal period are at risk of having lower body mass index percentile and FEV 1 percent predicted. What is New: • Children and adolescents with cystic fibrosis and history of meconium ileus have decreased bone mineral density and fat mass compared to patients without such history. • Lower lung function in children with MI coexists with suboptimal bone mineral density.