Growth and nutritional indexes in early life predict pulmonary function in cystic fibrosis

Objective: To determine the relation of growth and nutritional status to pulmonary function in young children with eystie fibrosis (CF). Study: design The relation of weight-for-age (WFA), height-for-age (HFA), percent ideal body weight (%IBW), and signs of lung disease at age 3 years with pulmonary function at age 6 years was assessed in 931 patients with CF. Associations of changes in WFA from age 3 to 6 on pulmonary function were also assessed. Results: WFA, HFA, and %IBW were poorly associated with lung disease at age 3 years, but all were strongly associated with pulmonary function at age 6 years. Those with WFA below the 5th percentile at age 3 had lower pulmonary function at age 6 compared with those above the 75th percentile (FEV₁: 86 ± 20 [SD] versus 102 ± 18% predicted, respectively). Pulmonary function was highest in those whose WFA remained >10th percentile from age 3 to 6 (FEV₁: 100 ± 19% predicted) and lowest in those who remained <10th percentile (84 ± 21% predicted). Patients with signs and symptoms of lung disease at age 3 years had lower pulmonary function at age 6 years. Conclusions: Aggressive intervention early in life aimed at growth and nutrition and/or lung disease may affect pulmonary function.