PDF(Pubmed)
Abstract：
Higher growth percentiles are associated with more favorable lung function in cystic fibrosis (CF), prompting the creation of CF Foundation (CFF) nutritional guidelines.
To describe early childhood growth trajectories within CF, to determine if growth trajectories are associated with differences in lung function at age six, and to identify factors that differ between trajectory groups.
Retrospective cohort study of children diagnosed with CF and born 2000-2011 using the US CFF Patient Registry. Annualized growth parameters prior to age six were included in group-based trajectory modeling to identify unique early life growth trajectories. FEV1 percent predicted (FEV1pp) at age six was compared between trajectory groups using linear regression. Factors associated with group membership were identified using multinomial logistic regression.
6,809 children met inclusion criteria. Six discrete growth trajectories were identified, including three groups that began with growth parameters >50th percentile, termed: \"always high\", \"gradual decliner\", \"rapid decliner\", and three which began with growth parameters <50th percentile, termed: \"rapid riser\", \"gradual riser\", \"always low\". FEV1pp at age six was highest for the Always High trajectory. The Always Low trajectory was nearly 10% lower than the Always High trajectory. Sex, ethnicity, newborn screening and pancreatic function were associated with trajectory class membership.
Distinct early life growth trajectories were identified within CF. Trajectories that met CFF nutritional guideline recommendations were associated with higher FEV1pp at age six. CF care teams should continue to partner with families to encourage interventions to support optimal growth to improve lung function in CF.
To describe early childhood growth trajectories within CF, to determine if growth trajectories are associated with differences in lung function at age six, and to identify factors that differ between trajectory groups.
Retrospective cohort study of children diagnosed with CF and born 2000-2011 using the US CFF Patient Registry. Annualized growth parameters prior to age six were included in group-based trajectory modeling to identify unique early life growth trajectories. FEV1 percent predicted (FEV1pp) at age six was compared between trajectory groups using linear regression. Factors associated with group membership were identified using multinomial logistic regression.
6,809 children met inclusion criteria. Six discrete growth trajectories were identified, including three groups that began with growth parameters >50th percentile, termed: \"always high\", \"gradual decliner\", \"rapid decliner\", and three which began with growth parameters <50th percentile, termed: \"rapid riser\", \"gradual riser\", \"always low\". FEV1pp at age six was highest for the Always High trajectory. The Always Low trajectory was nearly 10% lower than the Always High trajectory. Sex, ethnicity, newborn screening and pancreatic function were associated with trajectory class membership.
Distinct early life growth trajectories were identified within CF. Trajectories that met CFF nutritional guideline recommendations were associated with higher FEV1pp at age six. CF care teams should continue to partner with families to encourage interventions to support optimal growth to improve lung function in CF.
摘要：
背景：在囊性纤维化（CF）中，较高的生长百分位数与更有利的肺功能相关，促使建立CF基金会(CFF)营养指南。
目的：为了描述CF中的幼儿成长轨迹，以确定生长轨迹是否与六岁时的肺功能差异有关，并确定轨迹组之间不同的因素。
方法：使用美国CFF患者登记处对2000-2011年被诊断为CF的儿童进行回顾性队列研究。六岁之前的年化生长参数包括在基于组的轨迹建模中，以识别独特的早期生命生长轨迹。使用线性回归比较了6岁时的FEV1预测百分比（FEV1pp）。使用多项逻辑回归确定与组成员资格相关的因素。
结果：6,809名儿童符合纳入标准。确定了六个离散的生长轨迹，包括三个以生长参数>第50百分位数开始的组，称为：“总是很高”，“逐渐下降”，“快速下降”，三个以生长参数<50%开始，称为：“快速立管”，“逐渐上升”，“总是低”。6岁时的FEV1pp是“始终高”轨迹中最高的。始终低轨迹比始终高轨迹低近10%。性,种族,新生儿筛查和胰腺功能与轨迹类成员相关.
结论：在CF中确定了不同的早期生命生长轨迹。符合CFF营养指南建议的轨迹与6岁时较高的FEV1pp相关。CF护理团队应继续与家庭合作，鼓励干预措施，以支持最佳生长，以改善CF的肺功能。
目的：为了描述CF中的幼儿成长轨迹，
方法：使用美国CFF患者登记处对2000-2011年被诊断为CF的儿童进行回顾性队列研究。
结果：6,809名儿童符合纳入标准。
结论：在CF中确定了不同的早期生命生长轨迹。
