title: Growth status in children with cystic fibrosis based on the National Cystic Fibrosis Patient Registry data: evaluation of various criteria used to identify malnutrition.
abstract: OBJECTIVE
  The objectives of this study were to determine growth status and to identify malnutrition with various anthropometric indicators in children with cystic fibrosis (CF) based on cross-sectional analysis of the 1993 National CF Patient Registry data.
  
  
  METHODS
  Heights and weights of 13,116 children with CF were evaluated with percentile, percent of reference median, Z-score, and percent ideal weight-for-height based on National Center for Health Statistics/Centers for Disease Control growth references. Malnutrition was defined by four criteria: (1) height-for-age <5th percentile ("stunting") or weight-for-age <5th percentile ("wasting") (2) height-for-age <90% of reference median or weight-for-age <80% of reference median, (3) height-for-age <5th percentile or percent ideal weight-for-height <85%, and (4) height-for-age <90% of reference median or weight-for-height <85% of reference median.
  
  
  RESULTS
  Mean and median height- and weight-for-age were found to be at the 30th and 20th percentiles in children with CF. Malnutrition (height- or weight-for-age <5th percentile) was particularly pronounced in infants (47%) and adolescents (34%) and patients with newly diagnosed CF (44%). A significant sex difference (p < 0.01) in the occurrence of stunting (height-for-age <5th percentile) was observed during adolescence: boys 11 to 14 years of age showed lower occurrence of stunting (19%) compared with girls (29%), whereas the opposite trend was observed at 15 to 18 years (34% in male patients vs 28% in female patients).
  
  
  CONCLUSIONS
  Twenty percent of all children in the 1993 National CF Patient Registry were <5th percentile for height- or weight-for-age. A significant discrepancy was found when different criteria were used to distinguish "stunting" versus "wasting" in malnourished children with CF.
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine, Madison 53792, USA.
authors.forename: H C
authors.initials: HC
authors.lastname: Lai
authors.forename: M R
authors.initials: MR
authors.lastname: Kosorok
authors.forename: S A
authors.initials: SA
authors.lastname: Sondel
authors.forename: S T
authors.initials: ST
authors.lastname: Chen
authors.forename: S C
authors.initials: SC
authors.lastname: FitzSimmons
authors.forename: C G
authors.initials: CG
authors.lastname: Green
authors.forename: G
authors.initials: G
authors.lastname: Shen
authors.forename: S
authors.initials: S
authors.lastname: Walker
authors.forename: P M
authors.initials: PM
authors.lastname: Farrell
mesh_terms: D000293:Adolescent; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006130:Growth Disorders / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D009309:National Center for Health Statistics, U.S.; D009748:Nutrition Disorders / Q000145:classification / Q000150:complications / Q000175:diagnosis*; D012016:Reference Values; D012042:Registries; D012737:Sex Factors; D014481:United States; D019282:Wasting Syndrome / Q000175:diagnosis / Q000209:etiology