Early Life Growth Trajectories in Cystic Fibrosis are Associated with Pulmonary Function at Age 6 Years

To determine whether severity of lung disease at age 6 years is associated with changes in nutritional status before age 6 within individual children with cystic fibrosis (CF). Children with CF born between 1994 and 2005 and followed in the CF Foundation Patient Registry from age ≤2 through 7 years...

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Vydáno v:	The Journal of pediatrics Ročník 167; číslo 5; s. 1081 - 1088.e1
Hlavní autoři:	Sanders, Don B., Fink, Aliza, Mayer-Hamblett, Nicole, Schechter, Michael S., Sawicki, Gregory S., Rosenfeld, Margaret, Flume, Patrick A., Morgan, Wayne J.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Elsevier Inc 01.11.2015
Témata:	Body Height - physiology Body Mass Index Body Weight - physiology Child Child, Preschool Cystic Fibrosis - physiopathology Disease Progression Female Follow-Up Studies Forced Expiratory Volume - physiology Humans Infant Lung - physiopathology Male Nutritional Status Pediatrics Respiratory Function Tests Retrospective Studies Time Factors CFF FVC CF CFFPR FEV1 WFL CFTR NBS BMI CF transmembrane conductance regulator Forced vital capacity Cystic fibrosis CF Foundation Body mass index Forced expiratory volume in 1 second FEV 1 Weight-for-length CFF Patient Registry Newborn screening
ISSN:	0022-3476, 1097-6833
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Abstract	To determine whether severity of lung disease at age 6 years is associated with changes in nutritional status before age 6 within individual children with cystic fibrosis (CF). Children with CF born between 1994 and 2005 and followed in the CF Foundation Patient Registry from age ≤2 through 7 years were assessed according to changes in annualized weight-for-length (WFL) percentiles between ages 0 and 2 years and body mass index (BMI) percentiles between ages 2 and 6 years. The association between growth trajectories before age 6 and forced expiratory volume in 1 second (FEV1)% predicted at age 6-7 years was evaluated using multivariable linear regression. A total of 6805 subjects met inclusion criteria. Children with annualized WFL-BMI always >50th percentile (N = 1323 [19%]) had the highest adjusted mean (95% CI) FEV1 at 6-7 years (101.8 [100.1, 103.5]). FEV1 at 6-7 years for children whose WFL-BMI increased >10 percentile points by age 6 years was 98.3 (96.6, 100.0). This was statistically significantly higher than FEV1 for children whose WFL-BMI was stable (94.4 [92.6, 96.2]) or decreased >10 percentile points (92.9 [91.1, 94.8]). Among children whose WFL-BMI increased >10 percentile points, achieving and maintaining WFL-BMI >50th percentile at younger ages was associated with significantly higher FEV1 at 6-7 years. Within-patient changes in nutritional status in the first 6 years of life are significantly associated with FEV1 at age 6-7 years. The establishment of a clear relationship between early childhood growth measurements and later lung function suggests that early nutritional interventions may impact on eventual lung health.
AbstractList	To determine whether severity of lung disease at age 6 years is associated with changes in nutritional status before age 6 within individual children with cystic fibrosis (CF). Children with CF born between 1994 and 2005 and followed in the CF Foundation Patient Registry from age ≤2 through 7 years were assessed according to changes in annualized weight-for-length (WFL) percentiles between ages 0 and 2 years and body mass index (BMI) percentiles between ages 2 and 6 years. The association between growth trajectories before age 6 and forced expiratory volume in 1 second (FEV1)% predicted at age 6-7 years was evaluated using multivariable linear regression. A total of 6805 subjects met inclusion criteria. Children with annualized WFL-BMI always >50th percentile (N = 1323 [19%]) had the highest adjusted mean (95% CI) FEV1 at 6-7 years (101.8 [100.1, 103.5]). FEV1 at 6-7 years for children whose WFL-BMI increased >10 percentile points by age 6 years was 98.3 (96.6, 100.0). This was statistically significantly higher than FEV1 for children whose WFL-BMI was stable (94.4 [92.6, 96.2]) or decreased >10 percentile points (92.9 [91.1, 94.8]). Among children whose WFL-BMI increased >10 percentile points, achieving and maintaining WFL-BMI >50th percentile at younger ages was associated with significantly higher FEV1 at 6-7 years. Within-patient changes in nutritional status in the first 6 years of life are significantly associated with FEV1 at age 6-7 years. The establishment of a clear relationship between early childhood growth measurements and later lung function suggests that early nutritional interventions may impact on eventual lung health. OBJECTIVETo determine whether severity of lung disease at age 6 years is associated with changes in nutritional status before age 6 within individual children with cystic fibrosis (CF).STUDY DESIGNChildren with CF born between 1994 and 2005 and followed in the CF Foundation Patient Registry from age ≤2 through 7 years were assessed according to changes in annualized weight-for-length (WFL) percentiles between ages 0 and 2 years and body mass index (BMI) percentiles between ages 2 and 6 years. The association between growth trajectories before age 6 and forced expiratory volume in 1 second (FEV1)% predicted at age 6-7 years was evaluated using multivariable linear regression.RESULTSA total of 6805 subjects met inclusion criteria. Children with annualized WFL-BMI always >50th percentile (N = 1323 [19%]) had the highest adjusted mean (95% CI) FEV1 at 6-7 years (101.8 [100.1, 103.5]). FEV1 at 6-7 years for children whose WFL-BMI increased >10 percentile points by age 6 years was 98.3 (96.6, 100.0). This was statistically significantly higher than FEV1 for children whose WFL-BMI was stable (94.4 [92.6, 96.2]) or decreased >10 percentile points (92.9 [91.1, 94.8]). Among children whose WFL-BMI increased >10 percentile points, achieving and maintaining WFL-BMI >50th percentile at younger ages was associated with significantly higher FEV1 at 6-7 years.CONCLUSIONSWithin-patient changes in nutritional status in the first 6 years of life are significantly associated with FEV1 at age 6-7 years. The establishment of a clear relationship between early childhood growth measurements and later lung function suggests that early nutritional interventions may impact on eventual lung health. To determine whether severity of lung disease at age 6 years is associated with changes in nutritional status before age 6 within individual children with cystic fibrosis (CF). Children with CF born between 1994 and 2005 and followed in the CF Foundation Patient Registry from age ≤2 through 7 years were assessed according to changes in annualized weight-for-length (WFL) percentiles between ages 0 and 2 years and body mass index (BMI) percentiles between ages 2 and 6 years. The association between growth trajectories before age 6 and forced expiratory volume in 1 second (FEV1)% predicted at age 6-7 years was evaluated using multivariable linear regression. A total of 6805 subjects met inclusion criteria. Children with annualized WFL-BMI always >50th percentile (N = 1323 [19%]) had the highest adjusted mean (95% CI) FEV1 at 6-7 years (101.8 [100.1, 103.5]). FEV1 at 6-7 years for children whose WFL-BMI increased >10 percentile points by age 6 years was 98.3 (96.6, 100.0). This was statistically significantly higher than FEV1 for children whose WFL-BMI was stable (94.4 [92.6, 96.2]) or decreased >10 percentile points (92.9 [91.1, 94.8]). Among children whose WFL-BMI increased >10 percentile points, achieving and maintaining WFL-BMI >50th percentile at younger ages was associated with significantly higher FEV1 at 6-7 years. Within-patient changes in nutritional status in the first 6 years of life are significantly associated with FEV1 at age 6-7 years. The establishment of a clear relationship between early childhood growth measurements and later lung function suggests that early nutritional interventions may impact on eventual lung health. Objective To determine whether severity of lung disease at age 6 years is associated with changes in nutritional status before age 6 within individual children with cystic fibrosis (CF). Study design Children with CF born between 1994 and 2005 and followed in the CF Foundation Patient Registry from age ≤2 through 7 years were assessed according to changes in annualized weight-for-length (WFL) percentiles between ages 0 and 2 years and body mass index (BMI) percentiles between ages 2 and 6 years. The association between growth trajectories before age 6 and forced expiratory volume in 1 second (FEV1 )% predicted at age 6-7 years was evaluated using multivariable linear regression. Results A total of 6805 subjects met inclusion criteria. Children with annualized WFL-BMI always >50th percentile (N = 1323 [19%]) had the highest adjusted mean (95% CI) FEV1 at 6-7 years (101.8 [100.1, 103.5]). FEV1 at 6-7 years for children whose WFL-BMI increased >10 percentile points by age 6 years was 98.3 (96.6, 100.0). This was statistically significantly higher than FEV1 for children whose WFL-BMI was stable (94.4 [92.6, 96.2]) or decreased >10 percentile points (92.9 [91.1, 94.8]). Among children whose WFL-BMI increased >10 percentile points, achieving and maintaining WFL-BMI >50th percentile at younger ages was associated with significantly higher FEV1 at 6-7 years. Conclusions Within-patient changes in nutritional status in the first 6 years of life are significantly associated with FEV1 at age 6-7 years. The establishment of a clear relationship between early childhood growth measurements and later lung function suggests that early nutritional interventions may impact on eventual lung health.
Author	Fink, Aliza Sanders, Don B. Schechter, Michael S. Flume, Patrick A. Sawicki, Gregory S. Rosenfeld, Margaret Mayer-Hamblett, Nicole Morgan, Wayne J.
AuthorAffiliation	3 Department of Biostatistics, University of Washington, Seattle, WA 7 Departments of Medicine and Pediatrics, Medical University of South Carolina, Charleston, SC 6 Department of Pediatrics, Boston Children's Hospital, Boston, MA 4 Department of Pediatrics, University of Washington, Seattle, WA 2 Cystic Fibrosis Foundation, Bethesda, MD 5 Department of Pediatrics, Virginia Commonwealth University, Richmond, VA 8 Department of Pediatrics, University of Arizona, Tucson, AZ 1 Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
AuthorAffiliation_xml	– name: 3 Department of Biostatistics, University of Washington, Seattle, WA – name: 8 Department of Pediatrics, University of Arizona, Tucson, AZ – name: 1 Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI – name: 2 Cystic Fibrosis Foundation, Bethesda, MD – name: 6 Department of Pediatrics, Boston Children's Hospital, Boston, MA – name: 5 Department of Pediatrics, Virginia Commonwealth University, Richmond, VA – name: 4 Department of Pediatrics, University of Washington, Seattle, WA – name: 7 Departments of Medicine and Pediatrics, Medical University of South Carolina, Charleston, SC
Author_xml	– sequence: 1 givenname: Don B. orcidid: 0000-0001-6265-6249 surname: Sanders fullname: Sanders, Don B. email: dbsanders@pediatrics.wisc.edu organization: Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI – sequence: 2 givenname: Aliza surname: Fink fullname: Fink, Aliza organization: Cystic Fibrosis Foundation, Bethesda, MD – sequence: 3 givenname: Nicole surname: Mayer-Hamblett fullname: Mayer-Hamblett, Nicole organization: Department of Biostatistics, University of Washington, Seattle, WA – sequence: 4 givenname: Michael S. surname: Schechter fullname: Schechter, Michael S. organization: Department of Pediatrics, Virginia Commonwealth University, Richmond, VA – sequence: 5 givenname: Gregory S. surname: Sawicki fullname: Sawicki, Gregory S. organization: Department of Pediatrics, Boston Children's Hospital, Boston, MA – sequence: 6 givenname: Margaret surname: Rosenfeld fullname: Rosenfeld, Margaret organization: Department of Pediatrics, University of Washington, Seattle, WA – sequence: 7 givenname: Patrick A. surname: Flume fullname: Flume, Patrick A. organization: Departments of Medicine and Pediatrics, Medical University of South Carolina, Charleston, SC – sequence: 8 givenname: Wayne J. surname: Morgan fullname: Morgan, Wayne J. organization: Department of Pediatrics, University of Arizona, Tucson, AZ
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Keywords	CFF FVC CF CFFPR FEV1 WFL CFTR NBS BMI CF transmembrane conductance regulator Forced vital capacity Cystic fibrosis CF Foundation Body mass index Forced expiratory volume in 1 second FEV 1 Weight-for-length CFF Patient Registry Newborn screening
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Snippet	To determine whether severity of lung disease at age 6 years is associated with changes in nutritional status before age 6 within individual children with... Objective To determine whether severity of lung disease at age 6 years is associated with changes in nutritional status before age 6 within individual children... To determine whether severity of lung disease at age 6 years is associated with changes in nutritional status before age 6 within individual children with... OBJECTIVETo determine whether severity of lung disease at age 6 years is associated with changes in nutritional status before age 6 within individual children...
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SubjectTerms	Body Height - physiology Body Mass Index Body Weight - physiology Child Child, Preschool Cystic Fibrosis - physiopathology Disease Progression Female Follow-Up Studies Forced Expiratory Volume - physiology Humans Infant Lung - physiopathology Male Nutritional Status Pediatrics Respiratory Function Tests Retrospective Studies Time Factors
Title	Early Life Growth Trajectories in Cystic Fibrosis are Associated with Pulmonary Function at Age 6 Years
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