Growth assessment in Egyptian children with cystic fibrosis: A single center study

Abstract

Background: Poor clinical outcomes in cystic fibrosis are often associated with undernutrition. Nutritional status is an important prognostic marker, regardless of the level of respiratory function in the patient. Careful and repeated nutritional assessments allow for early detection of nutritional deterioration. Objectives: To assess the growth of cystic fibrosis children using different parameters as body mass index percentiles (BMIP) and standard anthropometric indexes, including height-for-age percentile (HAP), weight-for-age percentile (WAP) and compare between them as measures for nutritional failure in children with cystic fibrosis (CF). Methodology: This was a cross sectional study including fifty children of both sexes with CF below 12 years of age, recruited from the cystic fibrosis clinic, Specialized Children’s Hospital, Cairo University. Patients were subjected to full history taking including age at diagnosis, frequency of hospital admissions (per year), current medications and presence of complications. Thorough clinical examination was performed with special emphasis on anthropometric measurements including body weight, length/height, BMI calculation. Results: This study included 30 boys and 20 girls between 2 and 11 years old with a mean of 4.25 ± 2.30 yrs. Pancreatic insufficiency was found in 36% of patients, 28% had failure to thrive as the main complaint while 72% had recurrent chest infection as the main complaint. Growth assessment revealed that 21 patients (42%) were below −2 SDS for weight. As for BMI, 14 patients (28%) were below the 10th percentile. A highly significant negative correlation was reported between the weight SDS and the frequency of hospital admission (r = −0.412, p = 0.003). Furthermore, there was a highly statistical significant difference between the malnourished patients and the patients with average weight regarding the frequency of hospital admission (p < 0.01). As for BMI, there was a statistically significant negative correlation between the BMI and the frequency of hospital admission (r = −0.350, p = 0.013), with the different categories of BMI (malnourished, those who need nutritional reassessment, normal and obese) having highly statistical significant difference as regards the frequency of hospital admission (p < 0.01). Conclusion: Malnourished CF patients had the highest frequency of hospital admission. BMIP predicts nutritional failure more sensitively and accurately than conventional anthropometric indexes (WAP and HAP) in children with CF.

Keywords

• Cystic fibrosis
• BMI percentiles