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Title: A longitudinal study of the body composition of children with cystic fibrosis compared to healthy children using the four-component model with an assessment of clinical tools available for body composition measurements
Author: Williams, J. E.
Awarding Body: University College London (University of London)
Current Institution: University College London (University of London)
Date of Award: 2013
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Body composition (BC) is an important prognostic factor in patients with cystic fibrosis (CF). International guidelines recommend monitoring growth and nutritional status in children with CF using simple anthropometry. However, methodological issues with simple techniques are more significant in children due to growth and maturation, and even more problematic in patients, perhaps accounting for inconsistent findings in previous BC research in children with CF. My thesis addressed three aims: 1) comparison of BC in young children with CF and controls using the criterion four-component model (4CM), cross-sectionally and longitudinally using pair-, group-match and reference database comparison ; 2) investigation of relationships between BC and lung function (FEV1); and 3) evaluation of simpler BC techniques for clinical assessment of children with CF. Results 1) Using the 4CM I found sex differences not identified by simpler techniques; girls with CF had abnormal baseline body composition, whilst longitudinal analysis showed deteriorating fat-free mass (FFM) in both sexes. Conclusions differed according to the comparison group used, perhaps accounting for some inconsistencies between previous studies. 2) Contrary to previous research, using the 4CM fat mass was positively associated with FEV1 in girls; this association was not apparent at 2 year follow-up despite declining FEV1. FEV1 was associated with FFM in boys and bone mass in girls, in accord with previous research. 3) Simple BC techniques were not interchangeable, and dual-energy X-ray absorptiometry (DXA) on its own or in combination with bio-electrical impedance (BIA) gave results closest to the criterion method. Conclusion Using the 4CM, abnormal BC and associations between BC and lung function were detected, which were not apparent using simple anthropometry. The findings emphasise the importance of using appropriate techniques to measure BC in children with CF, and suggest that DXA with or without BIA may be most appropriate in clinical practice.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available