Anne Munck1, Rym Boulkedid2, Laurence Weiss3, Pierre Foucaud4, Nathalie Wizla-Derambure5, Philippe Reix6, François Bremont7, Jocelyne Derelle8, Julien Schroedt2, Corinne Alberti2. 1. Service des maladies digestives et respiratoires de l'enfant, CRCM, Hôpital Robert Debré, AP-HP, University Paris Diderot. 2. University Paris Diderot, Sorbonne Paris Cité, AP-HP, Inserm, Hôpital Robert Debré, Unité d'Epidémiologie Clinique, CIC-EC 1426, UMR 1123, Paris. 3. Service de pédiatrie, CRCM, Hôpital de Hautepierre, Strasbourg. 4. Service de pédiatrie et néonatologie, CRCM, Hôpital André Mignot, Versailles. 5. Service de pédiatrie, CRCM, Hôpital Universitaire Jeanne de Flandres, Lille. 6. Service de pédiatrie, CRCM, Hospices Civils de Lyon, UMR5558 (EMET), CNRS, LBBE, Université de Lyon, Villeurbanne. 7. Service de pédiatrie, CRCM, Hôpital d'Enfants Purpan, Toulouse. 8. Service de médecine infantile, CRCM, Hôpital d'Enfants, Nancy, France.
Abstract
OBJECTIVE: To evaluate nutritional status and associated factors in a cystic fibrosis (CF) cohort diagnosed by newborn screening and followed up to month 24. METHODS: A prospective longitudinal multicenter study assessing nutritional status according to pancreatic status, feeding modalities, prescriptions, pulmonary outcome, and biological nutritional parameters. RESULTS: One hundred and five infants were recruited and 99 completed the study. Nutritional care management prevented undernutrition and stunting in those with exocrine pancreatic sufficiency (EPS), but affected (13/87) 15% and (21/86) 24%, respectively, of infants with exocrine pancreatic insufficiency (EPI). The logistic regression model found a positive association between both weight and length z scores "at risk" at month 24, and initial pulmonary symptoms (odds ratio [OR] 0.06, P < 0.01 and OR 0.08, P < 0.01, respectively); these symptoms were less frequent when age at first visit was earlier than 1.2 months (33% vs 67%, P = 0.02); stunting was also associated with high-calorie density intake and Staphylococcus aureus (OR 0.05, P = 0.01 and OR 0.17, P < 0.01). Pulmonary outcome did not differ according to pancreatic status; breast-feeding for at least 3 months delayed first acquisition of Pseudomonas aeruginosa. Despite sodium and fat-soluble vitamin supplementation, half of both cohorts had low urinary sodium output and half of the EPI cohort had low vitamin D levels. CONCLUSIONS: Our data shed light on the fact that stunting was more frequent than undernutrition, while both parameters involved only patients with pancreatic insufficiency. Modalities of feeding were not associated with nutritional status; breast-feeding may provide some protection against acquisition of P aeruginosa.
OBJECTIVE: To evaluate nutritional status and associated factors in a cystic fibrosis (CF) cohort diagnosed by newborn screening and followed up to month 24. METHODS: A prospective longitudinal multicenter study assessing nutritional status according to pancreatic status, feeding modalities, prescriptions, pulmonary outcome, and biological nutritional parameters. RESULTS: One hundred and five infants were recruited and 99 completed the study. Nutritional care management prevented undernutrition and stunting in those with exocrine pancreatic sufficiency (EPS), but affected (13/87) 15% and (21/86) 24%, respectively, of infants with exocrine pancreatic insufficiency (EPI). The logistic regression model found a positive association between both weight and length z scores "at risk" at month 24, and initial pulmonary symptoms (odds ratio [OR] 0.06, P < 0.01 and OR 0.08, P < 0.01, respectively); these symptoms were less frequent when age at first visit was earlier than 1.2 months (33% vs 67%, P = 0.02); stunting was also associated with high-calorie density intake and Staphylococcus aureus (OR 0.05, P = 0.01 and OR 0.17, P < 0.01). Pulmonary outcome did not differ according to pancreatic status; breast-feeding for at least 3 months delayed first acquisition of Pseudomonas aeruginosa. Despite sodium and fat-soluble vitamin supplementation, half of both cohorts had low urinary sodium output and half of the EPI cohort had low vitamin D levels. CONCLUSIONS: Our data shed light on the fact that stunting was more frequent than undernutrition, while both parameters involved only patients with pancreatic insufficiency. Modalities of feeding were not associated with nutritional status; breast-feeding may provide some protection against acquisition of P aeruginosa.
Authors: Catherine M McDonald; Jessica A Alvarez; Julianna Bailey; Ellen K Bowser; Kristen Farnham; Mark Mangus; Laura Padula; Kathleen Porco; Mary Rozga Journal: J Acad Nutr Diet Date: 2020-06-19 Impact factor: 5.234
Authors: Leenath Thomas; Shincy T John; B Arul P Lionel; Grace Rebekah; Madhan Kumar; Anu Punnen; Sneha Varkki Journal: J Family Med Prim Care Date: 2021-05-31