Original ArticlePubertal Height Velocity and Associations with Prepubertal and Adult Heights in Cystic Fibrosis
Section snippets
Methods
The CFF Registry documents the diagnosis and follow-up evaluations of patients with CF seen at accredited centers in the US.23 Height data were reported annually before 1993 and quarterly after 1994. Therefore, patients born in 1984-1987 would have quarterly height data from 1994 (at age 7-10 years) and reached adulthood by 2008, the most recent year of CFF Registry data available for this study. Of the 4198 born in 1984-1987, 309 died, 951 were lost to follow-up before age 18 years, and 1076
HV Curve and Pubertal PHV Pattern
Figure 1 shows the height and HV curve of a child with CF fitted by the shape invariant model.24 This method yields more accurate PHV magnitude because it uses a smooth estimate from the fitted curve rather than that calculated from 2 adjacent heights (point “•”, the largest Y-axis value of all open circles).
Figure 2 shows the overall common shape of HV curves. Compared with healthy children,25 PHV in children with CF occurred later (0.5 years later in boys and 0.6 years later in girls) with
Discussion
With the use of a novel semi-parametric growth curve model,24 which can accommodate missing data, irregular measurement intervals, and patterns of growth that may not be well fitted by parametric models29, 30 used in previous studies,5, 10 our study generated new and important findings on pubertal growth in the CF population. First, we demonstrated that children with CF born in the mid-1980s still experienced D&A pubertal PHV compared with healthy children, but the delay and attenuation were
References (37)
- et al.
Better nutritional status in early childhood is associated with improved clinical outcomes and survival in patients with cystic fibrosis
J Pediatr
(2013) - et al.
Effectiveness of enteric coated pancreatic enzymes given before meals in reducing steatorrhea in children with cystic fibrosis
J Am Diet Assoc
(1992) - et al.
A comparison of survival, growth, and pulmonary function in patients with cystic fibrosis in Toronto and Boston
J Clin Epidemiol
(1988) - et al.
Nutritional assessment and management in cystic fibrosis
Am J Clin Nutr
(1992) - et al.
Comparison of body mass index percentile and percentage of ideal body weight for screening malnutrition in children with cystic fibrosis
Am J Clin Nutr
(2004) - et al.
Classification of malnutrition in cystic fibrosis: implications on evaluating and benchmarking clinical practices
Am J Clin Nutr
(2008) - et al.
Evidence-based practice recommendations for nutrition-related management of children and adults with cystic fibrosis and pancreatic insufficiency: results of a systematic review
J Am Diet Assoc
(2008) - et al.
Incorporating genetic potential when evaluating stature in children with cystic fibrosis
J Cyst Fibros
(2010) The changing epidemiology of cystic fibrosis
J Pediatr
(1993)- et al.
Clinical longitudinal standards for height and height velocity for North American children
J Pediatr
(1985)
Pancreatic enzyme therapy and clinical outcomes in patients with cystic fibrosis
J Pediatr
Nutrition in patients with cystic fibrosis: a European consensus
J Cystic Fibrosis
Immunoreactive trypsinogen (IRT) as a biomarker for cystic fibrosis: challenges in newborn dried blood spot screening
Mol Genet Metab
Genetic modifiers of nutritional status in cystic fibrosis
Am J Clin Nutr
Short stature and pubertal delay in cystic fibrosis
Pediatrician
Short stature and pubertal delay in male adolescents with cystic fibrosis. Androgen treatment
Am J Dis Child
Quantitating the effect of cystic fibrosis on linear growth by mathematical modeling of longitudinal growth curves
Growth Dev Aging
Relationship between clinical parameters and linear growth in children with cystic fibrosis
Am J Hum Biol
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Factors associated with pubertal growth outcomes in cystic fibrosis: Early Growth and Puberty in CF
2023, Journal of Cystic FibrosisEndocrine Complications of Cystic Fibrosis
2022, Clinics in Chest MedicineCitation Excerpt :Additionally, growth hormone carries the theoretic risk of worsening or precipitating CFRD, however data from the above MC trial did not support that concern. A study by Zhang in 2013 reviewed peak height velocity and adult height in CF,121 the authors found about a 6-month delay and 15% reduction in peak height velocity. This delay in peak height velocity may represent a second-hit following the early restriction seen in infants.
No gender differences in growth patterns in a cohort of children with cystic fibrosis born between 1986 and 1995
2019, Clinical NutritionCitation Excerpt :This did not allow to systematically collect data on pubertal status that may have affected the evaluation of the anthropometric indices, especially during adolescence, when a delay in puberty can be at least partially responsible for the differences between CF adolescents and healthy peers. A longitudinal study [28] from the USA carried out on 1862 CF children born in the period 1984–87 found peak height velocity delayed in 9%, attenuated in 21% and both delayed and attenuated in 5% of the children, with the attenuated group being shorter than those who had normal or delayed peak height velocity, while the delayed group reached a similar adult height than those showing normal peak height velocity. In the last few years, new biomarkers of early lung function deterioration have become available, such as the Lung Clearance Index (LCI) and clinical scores derived from computed tomography [29,30].
Evaluating the impact of 2006 Australasian Clinical Practice Guidelines for nutrition in children with cystic fibrosis in Australia
2018, Respiratory MedicineCitation Excerpt :This finding became very much apparent after adjusting the GEE model for sex, age, pancreatic status, dornase alfa (Pulmozyme), number of ever-colonised positive sample of Pseudomonas aeruginosa and G551D mutation. Our findings supports the results from the recent US studies which also demonstrated improvements in nutritional status in children with CF after implementation of quality improvement initiatives based on nutrition practice guidelines [40–42]. Notwithstanding, given the increasing prevalence of obese children in developed countries, it was important to rule out the possibility that improvement in nutritional outcomes of children with CF was partially due to changes in eating behaviour of a whole generation.
MicroRNAs link chronic inflammation in childhood to growth impairment and insulin-resistance
2018, Cytokine and Growth Factor ReviewsCitation Excerpt :Furthermore, mTOR regulates several downstream components such as Grb10 by phosphorylation, leading to a feedback inhibition of the PI3K and ERK-MAPK pathways [67]. Impaired linear growth is commonly encountered in children with chronic inflammatory conditions such as Cystic Fibrosis [68], Inflammatory Bowel Diseases [69], Juvenile Idiopathic Arthritis [70], Celiac disease and in Intrauterine Growth Restriction. MiRNAs reported as dysregulated in these diseases and their contribution to inflammation are listed in the following sections and are resumed in Table 1.
Growth in childhood chronic conditions
2018, Encyclopedia of Endocrine Diseases
Supported by The National Institutes of Health (R01DK072126). The authors declare no conflicts of interest.