TY - JOUR
T1 - Infant Body Mass Index or Weight-for-Length and Risk of Undernutrition in Childhood Among Children with Cystic Fibrosis
AU - Zysman-Colman, Zofia
AU - Munsar, Zoya
AU - Sheikh, Saba
AU - Rubenstein, Ronald C.
AU - Kelly, Andrea
N1 - Funding Information:
Z.M. funded by Cystic Fibrosis Foundation Student Traineeship awards: MUNSAR19H0, MUNSAR20H0, MUNSAR21H0. The authors declare no conflicts of interest.
Funding Information:
We thank the CFF for the use of the CFFPR data to conduct this study. We also thank the patients, care providers, and clinic coordinators at CF Centers throughout the US for their contributions to the CFFPR.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/4
Y1 - 2022/4
N2 - Objectives: To compare performance of weight-for-length and body mass index as estimators of undernutrition in children with cystic fibrosis (CF). Study design: We analyzed pediatric anthropometric data from the Cystic Fibrosis Foundation Patient Registry. Undernutrition was defined by weight-for-length z score (WFLZ) or body mass index z score (BMIZ) ≤–1 (15th-percentile). Group 1, reference group, consisted of subjects with both BMIZ and WFLZ >–1; group 2: BMIZ ≤–1 and WFLZ >–1; group 3: BMIZ >–1 and WFLZ ≤–1; and group 4: BMIZ and WFLZ ≤–1. Group differences in length-for-age-Z across ages 2-24 months were tested using generalized estimating equations. The association of group at age 2 months with BMIZ <–1 at age 6 years was tested using logistic regression adjusted for demographic and disease characteristics. Results: Overall, 163 482 anthropometric measurements were available from 12 640 individuals, of whom 16.8% were discordant for undernutrition status at age 2 months. Discordance (1.5%-10%) was less common with increasing age. Length-for-age-Z was lower in group 2 than group 1 and group 3 between birth and 24 months (P <.05). Odds of WFLZ-defined undernourished at 2 months were lower for shorter individuals (OR 1.5, CI 1.4-1.6, P <.001). Undernutrition risk at age 6 years was greater for group 2 vs group 3 (OR 1.9 vs 1.0, P <.001). Conclusions: Infants with cystic fibrosis classified as undernourished by BMIZ, but not WFLZ, had greater risk of undernourished status later in childhood. Infants with low BMIZ but normal WFLZ tended to be shorter, suggesting BMIZ may better capture undernourished status than WFLZ in shorter infants.
AB - Objectives: To compare performance of weight-for-length and body mass index as estimators of undernutrition in children with cystic fibrosis (CF). Study design: We analyzed pediatric anthropometric data from the Cystic Fibrosis Foundation Patient Registry. Undernutrition was defined by weight-for-length z score (WFLZ) or body mass index z score (BMIZ) ≤–1 (15th-percentile). Group 1, reference group, consisted of subjects with both BMIZ and WFLZ >–1; group 2: BMIZ ≤–1 and WFLZ >–1; group 3: BMIZ >–1 and WFLZ ≤–1; and group 4: BMIZ and WFLZ ≤–1. Group differences in length-for-age-Z across ages 2-24 months were tested using generalized estimating equations. The association of group at age 2 months with BMIZ <–1 at age 6 years was tested using logistic regression adjusted for demographic and disease characteristics. Results: Overall, 163 482 anthropometric measurements were available from 12 640 individuals, of whom 16.8% were discordant for undernutrition status at age 2 months. Discordance (1.5%-10%) was less common with increasing age. Length-for-age-Z was lower in group 2 than group 1 and group 3 between birth and 24 months (P <.05). Odds of WFLZ-defined undernourished at 2 months were lower for shorter individuals (OR 1.5, CI 1.4-1.6, P <.001). Undernutrition risk at age 6 years was greater for group 2 vs group 3 (OR 1.9 vs 1.0, P <.001). Conclusions: Infants with cystic fibrosis classified as undernourished by BMIZ, but not WFLZ, had greater risk of undernourished status later in childhood. Infants with low BMIZ but normal WFLZ tended to be shorter, suggesting BMIZ may better capture undernourished status than WFLZ in shorter infants.
UR - http://www.scopus.com/inward/record.url?scp=85122321113&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2021.11.059
DO - 10.1016/j.jpeds.2021.11.059
M3 - Article
C2 - 34871592
AN - SCOPUS:85122321113
SN - 0022-3476
VL - 243
SP - 116-121.e3
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -