Doulgeraki Artemis, Petrocheilou Argyri, Petrocheilou Glykeria, Chrousos George, Doudounakis Stavros-Eleftherios, Kaditis Athanasios G
Department of Bone and Mineral Metabolism, Institute of Child Health, Aghia Sophia Children's Hospital, Athens, Greece.
Cystic Fibrosis Center, Aghia Sophia Children's Hospital, Athens, Greece.
Eur J Pediatr. 2017 Jun;176(6):737-743. doi: 10.1007/s00431-017-2906-z. Epub 2017 Apr 13.
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 FEV (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 FEV (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).
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 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.
本研究的目的是探讨患有囊性纤维化(CF)的儿童和青少年出生时胎粪性肠梗阻(MI)病史是否会对其成年后的身体成分和肺功能产生不利影响。对作为常规护理一部分接受肺活量测定和双能X线吸收法(DXA)检查的CF儿童和青少年的数据进行了分析。使用一般线性模型评估MI(解释变量)与面积骨矿物质密度(全身减去头部-TBLH aBMD)、瘦组织质量(LTM)和脂肪量(FM)(结果)之间的关联。还探讨了TBLH aBMD、LTM和FM与第一秒用力呼气容积(FEV,附加结果)之间的潜在关系。纳入了101名CF受试者(平均年龄14±3岁),其中19名(18.8%)有MI病史。在对其他变量进行调整后,MI病史与FEV(P = 0.04)、TBLH aBMD(P = 0.03)和FM(P < 0.01)之间存在负相关,但MI病史与LTM之间无负相关(P = 0.07)。肺功能与TBLH aBMD(P < 0.01)和LTM(P = 0.02)呈正相关,但与FM无正相关(P = 0.20)。
在患有CF的儿童和青少年中,有MI病史的患者骨矿物质密度、FM和肺功能较低。已知信息:• 在患有囊性纤维化的儿童和青少年中,新生儿期有胎粪性肠梗阻病史的患者有较低的体重指数百分位数和预测FEV百分比的风险。新发现:• 与无此类病史的患者相比,患有囊性纤维化且有胎粪性肠梗阻病史的儿童和青少年骨矿物质密度和脂肪量降低。• 患有MI的儿童肺功能较低与骨矿物质密度欠佳并存。