Height Assessment in the Dutch-Origin Pediatric Cystic Fibrosis Population.
BACKGROUND
Height evaluation is an integral part of cystic fibrosis (CF) care. Height is compared with reference values by converting it to height-for-age (HFA) z scores. However, HFA z scores do not adjust for genetic potential (ie, target height [TH]), which could result in an incorrect estimation of the height.


METHODS
To evaluate the magnitude of this potential problem, we assessed the agreement between HFA and HFA-adjusted-for-TH (HFA/TH) z scores in 474 Dutch children with CF.


RESULTS
In this study sample, HFA z scores were -0.07 (95% confidence interval, -0.02 to -0.12) lower than HFA/TH z scores. When HFA and HFA/TH z scores were subdivided into 4 categories (≥0, <0 and ≥-1, <-1 and ≥-2, and ≤-2), a moderate agreement was found. HFA z scores were classified lower than HFA/TH z scores in 21% of the measurements and higher in 15% of the measurements.


CONCLUSIONS
In clinical routine, height evaluation based on HFA may result in underestimation or overestimation of height growth, which may induce inappropriate nutrition interventions.
1 Internal Medicine and Dermatology, Dietetics, and Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands.
Janna W
JW
Woestenenk
2 The Dutch CF Foundation (NCFS), Baarn, the Netherlands.
Vincent A M
VA
Gulmans
3 Department of Pediatric Pulmonology, and Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands.
Cornelis K
CK
van der Ent
4 Department of Pediatric Gastroenterology, and Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands.
Roderick H J
RH
Houwen
D000293:Adolescent; D041923:Adolescent Development; D017195:Adolescent Nutritional Physiological Phenomena; D000367:Age Factors; D001827:Body Height; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000503:physiopathology*; D003951:Diagnostic Errors / Q000517:prevention & control*; D006130:Growth Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D009426:Netherlands; D015596:Nutrition Assessment; D009752:Nutritional Status; D012042:Registries; D012720:Severity of Illness Index
body height; cystic fibrosis; growth; pediatrics; target height