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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Bibliographic Details
Published in:The Journal of pediatrics Vol. 167; no. 5; pp. 1081 - 1088.e1
Main Authors: Sanders, Don B., Fink, Aliza, Mayer-Hamblett, Nicole, Schechter, Michael S., Sawicki, Gregory S., Rosenfeld, Margaret, Flume, Patrick A., Morgan, Wayne J.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.11.2015
Subjects:
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
Online Access:Get full text
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Summary: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.
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ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2015.07.044