Growth status in children with cystic fibrosis based on the National Cystic Fibrosis Patient Registry data: evaluation of various criteria used to identify malnutrition

J Pediatr. 1998 Mar;132(3 Pt 1):478-85. doi: 10.1016/s0022-3476(98)70024-1.


Objectives: The objectives of this study were to determine growth status and to identify malnutrition with various anthropometric indicators in children with cystic fibrosis (CF) based on cross-sectional analysis of the 1993 National CF Patient Registry data.

Methods: Heights and weights of 13,116 children with CF were evaluated with percentile, percent of reference median, Z-score, and percent ideal weight-for-height based on National Center for Health Statistics/Centers for Disease Control growth references. Malnutrition was defined by four criteria: (1) height-for-age <5th percentile ("stunting") or weight-for-age <5th percentile ("wasting") (2) height-for-age <90% of reference median or weight-for-age <80% of reference median, (3) height-for-age <5th percentile or percent ideal weight-for-height <85%, and (4) height-for-age <90% of reference median or weight-for-height <85% of reference median.

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 pronounced in infants (47%) and adolescents (34%) and patients with newly diagnosed CF (44%). A significant sex difference (p < 0.01) in the occurrence of stunting (height-for-age <5th percentile) was observed during adolescence: boys 11 to 14 years of age showed lower occurrence of stunting (19%) compared with girls (29%), whereas the opposite trend was observed at 15 to 18 years (34% in male patients vs 28% in female patients).

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 children with CF.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Body Height
  • Body Weight
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / physiopathology
  • Diagnosis, Differential
  • Female
  • Growth Disorders / diagnosis
  • Growth Disorders / etiology
  • Humans
  • Infant
  • Male
  • National Center for Health Statistics, U.S.
  • Nutrition Disorders / classification
  • Nutrition Disorders / complications
  • Nutrition Disorders / diagnosis*
  • Reference Values
  • Registries
  • Sex Factors
  • United States
  • Wasting Syndrome / diagnosis
  • Wasting Syndrome / etiology