Higher Growth Percentile at 6 Years of Age Associated With Better Lung Function in CF

A new study has determined that early childhood growth trajectories are associated with lung function in patients with cystic fibrosis (CF). The research observed higher forced expiratory volume in 1 second expressed as the percentage of predicted value (FEV_1pp) in children with CF with trajectories that met the Cystic Fibrosis Foundation (CFF) nutritional guidelines.

“We performed a retrospective cohort study of early life growth trajectories in children with CF utilizing the Cystic Fibrosis Foundation Patient Registry (CFFPR),” the authors wrote in the study, published in the Journal of Cystic Fibrosis. “The primary outcome of interest was the best attained (highest) FEV_1pp based on the Global Lung Initiative reference equations between 6 and 6.99 years, the first age at which spirometry can be reliably performed.”

The research team included 6809 children with CF enrolled in the CFFPR, which is a longitudinal, encounter-based registry, between 2000 and 2011. Growth parameters and weight-for-length and/or body mass index data were collected on all children.

Group-based trajectory modeling was employed to determine the distinct growth trajectories of the children up to 6 years of age. This approach revealed 6 specific early-life growth trajectories in the cohort, 3 of which represented growth trajectories above the 50^th percentile; the remaining 3 were those below the 50^th percentile.

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The results showed that at 6 years of age, the highest FEV_1pp was observed in children with the highest growth trajectories, and the lowest FEV_1pp was found in those with the lowest growth trajectories. Girls were less likely to be in the top 2 growth trajectories, a finding consistent with sex differences observed in older children with CF and highlighting the need for extra attention to early growth among young female patients.

The authors conclude that optimizing nutritional status in early childhood is an essential aspect of CF management in young patients to prevent malnutrition, improve lung function, and ultimately improve outcomes.

Reference

Psoter KJ, Dickinson KM, Riekert KA, Collaco JM. Early life growth trajectories in cystic fibrosis are associated with lung function at age six. J Cyst Fibros. Published online February 28, 2023. doi:10.1016/j.jcf.2023.02.008