title: Nutritional status of adolescents with cystic fibrosis treated at a reference center in the southeast region of Brazil.
abstract: BACKGROUND
  Several factors can interfere with the full physical and emotional growth of adolescents, among them chronic diseases. The aim was to determine the nutritional status of adolescents and to associate it with puberty, pancreatic sufficiency, lung function and age range of Cystic Fibrosis (CF) diagnosis.
  
  
  METHODS
  An observational, cross-sectional, retrospective and analytical study was conducted using the data of medical records.
  
  
  METHODS
  Reference center in the northeastern region of the state of São Paulo - Brazil.
  
  
  METHODS
  All adolescents with CF attended in 2010 were included. Some variables included: pancreatic sufficiency (steatocrit >2 %), pancreatic enzymes replacement (yes/no), pubertal status-Tanner criteria (prepubertal: M1/G1, pubertal: M2/G2 to M4/G4, postpubertal: M5/G5), age at CF diagnosis (<2 and ≥2 years of age), Lung function, measured as a predicted forced expiratory volume in 1 s (FEV1). Main outcome measures Nutritional indicators: body mass index for age (BMI/A) and height for age (H/A) with z-score calculated with Anthro Plus software. Cut-off reference points: ≥ z-score -3 and < z-score -2 (thinness); z-score -2 and ≤ z-score-z +1 (normal weight); >z-score +1 (overweight or obesity), and z-score <-2 (low or very low H/A). The groups were compared by the Kruskal-Wallis test. Level of significance: p<0.05.
  
  
  RESULTS
  Thirty adolescents. Median (min;max) age: 14.4 (10.1;19.8) years. BMI/A and H/A z-score, respectively: early diagnosis of CF (-0.8; -1.1) or late diagnosis of CF (-0.5;-0.8); with pancreatic insufficiency (-0.7; -0.8) or without pancreatic insufficiency (-0.8; -0.5) and prepubertal (-0.8; -0.7) pubertal (-0.2; -1.5) or postpubertal (-0.7; -0.5). No significant difference (p>0.05) was observed. Patients with and without pancreatic insufficiency, presented H/A borderline z-score (p=0.05). Association between H/A and FEV1 was borderline (p=0.05).
  
  
  CONCLUSIONS
  Adolescents presented adequate nutritional status, although with slightly lower values than those of developed countries. FEV1 lower levels occurred more frequently in adolescents with low H/A.
authors.affiliation: Department of Medicine, Federal University of São Carlos, São Carlos, São Paulo, Brazil. irciampo@gmail.com.|Department of Pediatrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. irciampo@gmail.com.
authors.forename: Ieda Regina Lopes
authors.initials: IR
authors.lastname: Del Ciampo
authors.affiliation: Department of Pediatrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Luiz Antonio
authors.initials: LA
authors.lastname: Del Ciampo
authors.affiliation: Department of Pediatrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Regina
authors.initials: R
authors.lastname: Sawamura
authors.affiliation: Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Laiane Renolfi
authors.initials: LR
authors.lastname: de Oliveira
authors.affiliation: Department of Pediatrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Maria Inez Machado
authors.initials: MI
authors.lastname: Fernandes
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009752:Nutritional Status; D011627:Puberty / Q000502:physiology*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D055815:Young Adult