Longitudinal relationship among growth, nutritional status, and pulmonary function in children with cystic fibrosis: analysis of the Cystic Fibrosis Foundation National CF Patient Registry.
OBJECTIVE
To determine prospectively the relationship among growth, nutritional status, and pulmonary function over a 4-year period in a large cohort of children with cystic fibrosis (CF).


METHODS
CF Foundation National CF Patient Registry data collected from 1991 to 1995 for 968 children (507 male) aged 5 to 8 years with pancreatic insufficiency and forced expiratory volume in 1 second within 60% to 140% of predicted values (FEV(1)%) were analyzed longitudinally. Variables hypothesized to affect FEV(1)% included age, sex, z scores for height, weight, percent of height-appropriate body weight, and annual number of days hospitalized.


RESULTS
The significant decline in FEV(1)% was curvilinear and dependent on baseline FEV(1)%; children with initial FEV(1)% > or = 90 declined 2.6 U/y more than those with initial FEV(1)% <90. Boys gained but girls declined in z scores for height. Girls decreased in z scores for weight at a greater rate than boys. The z scores for weight and percent of height-appropriate body weight were significantly associated with longitudinal changes in FEV(1)%, after adjustment was done for hospitalizations.


CONCLUSIONS
Growth, nutritional status, and pulmonary function are not stable in prepubertal children with CF and pancreatic insufficiency. Important sex-related differences in growth occur before puberty. Growth and nutritional status are associated with changes in FEV(1)%, suggesting that nutritional intervention may slow the decline in pulmonary function in children with CF.
Zemel
B S
BS
Divisions of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, Pennsylvania 19104-4399, USA.
Jawad
A F
AF
FitzSimmons
S
S
Stallings
V A
VA
D001827:Body Height; D001835:Body Weight; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000503:physiopathology*; D018450:Disease Progression; D010188:Exocrine Pancreatic Insufficiency / Q000150:complications; D005260:Female; D005541:Forced Expiratory Volume; D006128:Growth; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D008297:Male; D009752:Nutritional Status; D011446:Prospective Studies