Body composition and lung function in children with cystic fibrosis and meconium ileus

Eur J Pediatr. 2017 Jun;176(6):737-743. doi: 10.1007/s00431-017-2906-z. Epub 2017 Apr 13.

Abstract

The aim of this study was to explore whether history of meconium ileus (MI) at birth in children and adolescents with cystic fibrosis (CF) adversely affects body composition and lung function in later life. Data of children and adolescents with CF who underwent spirometry and DXA as part of their routine care were analyzed. Associations between MI (explanatory variable) and areal bone mineral density (total body less head-TBLH aBMD), lean tissue mass (LTM), and fat mass (FM) (outcomes) were assessed using general linear models. Potential relationships of TBLH aBMD, LTM, and FM with FEV1 (additional outcome) were also explored. One hundred and one subjects with CF (mean age 14 ± 3 years) were included, 19 (18.8%) of whom had history of MI. Negative associations were demonstrated between history of MI and FEV1 (P = 0.04), TBLH aBMD (P = 0.03), and FM (P < 0.01) but not between history of MI and LTM (P = 0.07) after adjustment for other variables. Lung function was positively associated with TBLH aBMD (P < 0.01) and LTM (P = 0.02) but not with FM (P = 0.20).

Conclusion: Among children and adolescents with CF, those with history of MI have lower bone mineral density, FM, and lung function. What is Known: • Among children and adolescents with cystic fibrosis, those with history of meconium ileus in the neonatal period are at risk of having lower body mass index percentile and FEV 1 percent predicted. What is New: • Children and adolescents with cystic fibrosis and history of meconium ileus have decreased bone mineral density and fat mass compared to patients without such history. • Lower lung function in children with MI coexists with suboptimal bone mineral density.

Keywords: Body composition; Cystic fibrosis; Lung function; Meconium ileus.

MeSH terms

  • Absorptiometry, Photon
  • Adolescent
  • Body Composition*
  • Bone Density*
  • Child
  • Cystic Fibrosis / complications
  • Cystic Fibrosis / physiopathology*
  • Female
  • Forced Expiratory Volume
  • Humans
  • Logistic Models
  • Lung / physiopathology*
  • Male
  • Malnutrition / diagnosis
  • Malnutrition / etiology
  • Meconium Ileus / complications
  • Meconium Ileus / physiopathology*
  • Odds Ratio
  • Retrospective Studies
  • Spirometry
  • Young Adult