Child Development, Exercise, and Physical Literacy Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. Box 85090, 3508 EA Utrecht, The Netherlands.
Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands.
Ther Adv Respir Dis. 2022 Jan-Dec;16:17534666211070143. doi: 10.1177/17534666211070143.
[1] To investigate the cardiorespiratory fitness (CRF) levels in children and adolescents with cystic fibrosis (CF) with no ventilatory limitation (ventilatory reserve ⩾ 15%) during exercise, and [2] to assess which physiological factors are related to CRF.
A cross-sectional study design was used in 8- to 18-year-old children and adolescents with CF. Cardiopulmonary exercise testing was used to determine peak oxygen uptake normalized to body weight as a measure of CRF. Patients were defined as having 'low CRF' when CRF was less than 82%predicted. Physiological predictors used in this study were body mass index z-score, lung infection, impaired glucose tolerance (IGT) including CF-related diabetes, CF-related liver disease, sweat chloride concentration, and self-reported physical activity. Backward likelihood ratio (LR) logistic regression analysis was used.
Sixty children and adolescents (51.7% boys) with a median age of 15.3 years (25th-75th percentile: 12.9-17.0 years) and a mean percentage predicted forced expiratory volume in 1 second of 88.5% (±16.9) participated. Mean percentage predicted CRF (ppVO) was 81.4% (±12.4, range: 51%-105%). Thirty-three patients (55.0%) were classified as having 'low CRF'. The final model that best predicted low CRF included IGT ( = 0.085; Exp(B) = 6.770) and lung infection (p = 0.095; Exp(B) = 3.945). This model was able to explain between 26.7% and 35.6% of variance.
CRF is reduced in over half of children and adolescents with CF with normal ventilatory reserve. Glucose intolerance and lung infection seem to be associated to low CRF in children and adolescents with CF.
[1] 研究无通气限制（通气储备≥15%）的囊性纤维化（CF）儿童和青少年在运动中的心肺适应能力（CRF）水平，[2] 评估哪些生理因素与 CRF 相关。
采用 8 至 18 岁 CF 患儿的横断面研究设计。心肺运动测试用于确定峰值摄氧量与体重的比值作为 CRF 的衡量标准。当 CRF 低于预测值的 82%时，患者被定义为“低 CRF”。本研究中使用的生理预测因子包括体重指数 z 评分、肺部感染、葡萄糖耐量受损（IGT）包括 CF 相关糖尿病、CF 相关肝病、汗液氯化物浓度和自我报告的身体活动。使用后向似然比（LR）逻辑回归分析。
共有 60 名儿童和青少年（51.7%为男孩）参加了研究，中位年龄为 15.3 岁（25-75 百分位：12.9-17.0 岁），平均预测用力呼气量占预计值的百分比为 88.5%（±16.9）。平均预测 CRF（ppVO）为 81.4%（±12.4，范围：51%-105%）。33 名患者（55.0%）被归类为“低 CRF”。最佳预测低 CRF 的最终模型包括 IGT（=0.085；Exp（B）=6.770）和肺部感染（p=0.095；Exp（B）=3.945）。该模型能够解释 26.7%至 35.6%的变异性。
超过一半的 CF 患儿和青少年在通气储备正常的情况下，CRF 降低。葡萄糖耐量受损和肺部感染似乎与 CF 患儿和青少年的低 CRF 相关。
