Assessment of nutritional status in children with cystic fibrosis: conventional anthropometry and bioelectrical impedance analysis. A cross-sectional study in Dutch patients.
BACKGROUND
Assessment of nutritional status in children with cystic fibrosis (CF) is clinically relevant. Methods to measure nutritional status should be reliable and non-invasive, and reference values should be available.


OBJECTIVE
To compare weight and height measurements and measurements of specific body compartments in children with CF.


METHODS
In a cross-sectional survey of 58 children with CF (28 females), we compared height and weight (expressed as: weight-for-height, body mass index (BMI), height-for-age and weight-for-age) with fat mass (skinfold sum (SFS)), muscle mass (upper arm circumference (UAC)) and bioelectrical impedance analysis (BIA). Results were expressed as Z-scores, using Dutch reference values.


RESULTS
BMI and weight-for-height were within the normal range (mean Z-score (range): -0.13 (-1.5, 2.7) and -0.02 (-1.7, 2.8)). Weight and height corrected for age were below normal (mean Z-score (range): -0.79 (-2.4, -0.05) and -1.2 (-2.8, 1.4) (P<0.01)). Lean body mass by skinfold sum (LBM(sfs)), UAC and BIA were also significantly below reference values (mean Z-score (range): -0.9 (-2.2, 1.8), -0.95 (-2.4, 1.8) and -1.1 (-3.6, 1.0) (P<0.01)). Lean body mass (LBM) by BIA correlated with LBM(sfs). BIA systematically underestimated LBM in both CF patients and in control subjects.


CONCLUSIONS
Nutritional status of children with CF must be evaluated, using age-corrected weight and height expressed in Z-score. LBM estimated by SFS, UAC and by BIA appear to be useful, although longitudinal studies in CF children should be performed to evaluate their clinical significance in detecting changes in nutritional status.
Department of Pediatrics, Section of Gastroenterology, Erasmus Medical Centre Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands. mgroeneweg@planet.nl
Michael
M
Groeneweg
Suzan
S
Tan
Annemieke M
AM
Boot
Johan C
JC
de Jongste
Jan
J
Bouquet
Maarten
M
Sinaasappel
D000293:Adolescent; D000886:Anthropometry / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000503:physiopathology*; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D009752:Nutritional Status / Q000502:physiology*; D012720:Severity of Illness Index