GROWTH STATUS IN CHILDREN WITH CYSTIC-FIBROSIS BASED ON THE NATIONAL CYSTIC-FIBROSIS PATIENT REGISTRY DATA - EVALUATION OF VARIOUS CRITERIAUSED TO IDENTIFY MALNUTRITION

Objectives: The objectives of this study were to determine growth stat us and to identify malnutrition with various anthropometric indicators in children with cystic fibrosis (CF) based on cross-sectional analys is of the 1993 National CF Patient Registry data. Methods: Heights and weights of 13,116 children with CF were evaluated with percentile, pe rcent of reference median, Z-score, and percent ideal weight-for-heigh t based on National Center for Health Statistics/Centers for Disease C ontrol growth references. Malnutrition was defined by four criteria: ( 1) height-for-age <5th percentile (''stunting'') or weight-for-age <5t h percentile (''wasting'') (2) height-for-age <90% of reference median or weight-for-age <80% of reference median, (3) height-for-age <5th p ercentile or percent ideal weight-for-height <85%, and (4) height-for- age <90% of reference median or weight-for-height <85% of reference me dian. Results: Mean and median height-and weight-for-age were found to be at the 30th and 20th percentiles in children with CF. Malnutrition (height- or weight-for-age <5th percentile) was particularly pronounc ed in infants (47%) and adolescents (34%) and patients with newly diag nosed CF (44%). A significant sex difference (p < 0.01) in the occurre nce of stunting (height-for-age <5th percentile) was observed during a dolescence: boys 11 to 14 years of age showed lower occurrence of stun ting (19%) compared with girls (29%), whereas the opposite trend was o bserved at 15 to 18 years (34% in male patients vs 28% in female patie nts). Conclusion: Twenty percent of all children in the 1993 National CF Patient Registry were <5th percentile for height-or weight-for-age. A significant discrepancy was found when different criteria were used to distinguish ''stunting'' versus ''wasting'' in malnourished childr en with CF.