Better Nutritional Status in Early Childhood Is Associated with Improved Clinical Outcomes and Survival in Patients with Cystic Fibrosis
Better Nutritional Status in Early Childhood Is Associated with Improved Clinical Outcomes and Survival in Patients with Cystic Fibrosis
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DOI：
10.1016/j.jpeds.2012.08.040
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发表时间：
2013-03-01
影响因子：
5.1
通讯作者：
Borowitz, Drucy
中科院分区：
文献类型：
--
作者：
Yen, Elizabeth H.;Quinton, Hebe;Borowitz, Drucy
目的评估生命早期营养状况与身高增长的时间和速度、肺功能、囊性纤维化并发症和生存率之间的关系。使用囊性纤维化基金会登记处（US）1989年至1992年出生患者的数据进行的观察性研究结果4岁时的年龄别体重百分位数（weight-for-age percentile，WAP）与整个儿童期的年龄别身高比值呈正相关。年龄4岁的WAP >10%与6-18岁的肺功能较好相关。在当前WAP > 50%的男孩和女孩中，青春期身高峰值速度接近但仍低于健康参考人群。到18岁时，4岁WAP >50%的患者发生急性肺加重的次数较少，住院天数较少，葡萄糖耐量受损或糖尿病的发生率较低。患者达到更高的年龄4年WAP和身高年龄sweetles有一个生存优势，在整个childhood.Conclusion研究的人群中，更大的体重在4岁时与更高的身高，更好的肺功能，更少的并发症囊性纤维化，并通过年龄18年更好的生存。此外，平均而言，青春期前后年龄别体重的增加与青春期身高增长的克里思和时间的改善有关。（J Pediatr 2013;162：530-5）。
Objectives To evaluate the relationship between nutritional status early in life and the timing and velocity of height growth, lung function, complications of cystic fibrosis, and survival.Study design Prospective, observational study using data from the Cystic Fibrosis Foundation Registry (US) for patients born between 1989 and 1992 (n = 3142).Results Weight-for-age percentile (WAP) at 4 years of age was positively associated with height-for-age percentiles throughout childhood. Age 4 years WAP >10% was associated with better lung function from 6-18 years of age. In boys and girls with current WAP >50%, peak pubertal height velocities approximated but remained lower than that of the healthy reference population. By age 18 years, patients with an age 4 years WAP >50% suffered fewer acute pulmonary exacerbations, spent fewer days in the hospital, and had lower rates of impaired glucose tolerance or diabetes. Patients attaining higher age 4 years WAP and height-for-age percentiles had a survival advantage throughout childhood.Conclusion For the population studied, greater weight at age 4 years is associated with greater height, better pulmonary function, fewer complications of cystic fibrosis, and better survival through age 18 years. Furthermore, greater weight-for-age in the peripubertal period is associated on average with improved tempo and timing of pubertal height growth. (J Pediatr 2013;162:530-5).