title: Adolescent development and energy expenditure in females with cystic fibrosis.
abstract: OBJECTIVE
  Poor nutrition and growth status are common in people with cystic fibrosis (CF), and females often have a worse clinical course. Relationships between sexual maturity, nutrition, resting energy expenditure (REE), and pulmonary status in females with CF and pancreatic insufficiency (PI) were evaluated.
  
  
  METHODS
  Pre- and post-menarcheal females with CF and PI (8-29 yr) were compared to healthy females. Z-scores for growth and body composition, anthropometry and DEXA were assessed. REE was measured in all subjects and pulmonary function in CF.
  
  
  RESULTS
  Compared to healthy females (n=28, 14.6+/-4.1 yr), females with CF (n=16, 14.7+/-4.4 yr) had lower height Z (-0.1+/-0.9 versus -0.9+/-0.9, P=0.009) and muscle area Z (0.8+/-1.3 versus -0.4+/-1.2, P=0.007), and higher REE (100+/-10 versus 110+/-11% predicted, P=0.008). Difference in REE was more pronounced for post-menarcheal girls. REE adjusted for fat and fat-free mass was significantly higher with CF (+110 calories/day), and declined with menarcheal age in all subjects. FEV1 was positively associated with BMI Z score, and negatively associated with age at menarche.
  
  
  CONCLUSIONS
  Height and muscle stores were reduced and REE elevated in subjects with CF compared to healthy controls. Poorer growth and nutritional status and delayed menarche were associated with poorer pulmonary function in CF and were likely related to the cumulative effect of energy imbalance on growth and body composition.
authors.affiliation: Department of Pediatrics, Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, The University of Pennsylvania School of Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. stallingsv@email.chop.edu
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Stallings
authors.forename: Jean L
authors.initials: JL
authors.lastname: Tomezsko
authors.forename: Joan I
authors.initials: JI
authors.lastname: Schall
authors.forename: Maria R
authors.initials: MR
authors.lastname: Mascarenhas
authors.forename: Nicolas
authors.initials: N
authors.lastname: Stettler
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Scanlin
authors.forename: Babette S
authors.initials: BS
authors.lastname: Zemel
mesh_terms: D000293:Adolescent; D000328:Adult; D001481:Basal Metabolism / Q000502:physiology; D001823:Body Composition / Q000502:physiology; D001827:Body Height / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D002153:Calorimetry, Indirect; D016022:Case-Control Studies; D002648:Child; D003550:Cystic Fibrosis / Q000378:metabolism / Q000503:physiopathology*; D004734:Energy Metabolism / Q000502:physiology*; D010188:Exocrine Pancreatic Insufficiency / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007408:Intestinal Absorption; D008572:Menarche / Q000502:physiology; D009752:Nutritional Status; D012129:Respiratory Function Tests; D012741:Sexual Maturation / Q000502:physiology*