Energy and calcium stores are preserved in girls and young women with CF, independent of disease severity: An explanation for the 'gender gap'?

Greer, R. M., Buntain, H. M., Francis, P. W., Lewindon, P. J., Batch, J. A., O'Rourke, P. K. and Bell, S. C. (2004). Energy and calcium stores are preserved in girls and young women with CF, independent of disease severity: An explanation for the 'gender gap'?. In: V. Chernick, The Eighteenth Annual North American Cystic Fibrosis Conference. 18th Annual North American Cystic Fibrosis Conference, St. Louis, U.S.A., (336-336). 14-17 Oct, 2004. doi:10.1002/ppul.20143

Author Greer, R. M.
Buntain, H. M.
Francis, P. W.
Lewindon, P. J.
Batch, J. A.
O'Rourke, P. K.
Bell, S. C.
Title of paper Energy and calcium stores are preserved in girls and young women with CF, independent of disease severity: An explanation for the 'gender gap'?
Conference name 18th Annual North American Cystic Fibrosis Conference
Conference location St. Louis, U.S.A.
Conference dates 14-17 Oct, 2004
Proceedings title The Eighteenth Annual North American Cystic Fibrosis Conference   Check publisher's open access policy
Place of Publication Hoboken, U.S.A.
Publisher John Wiley & Sons
Publication Year 2004
DOI 10.1002/ppul.20143
ISSN 8755-6863
Editor V. Chernick
Volume 38
Issue S27
Start page 336
End page 336
Total pages 1
Collection year 2005
Language eng
Abstract/Summary Bioenergetics differ between males and females of many species. Human females apportion a substantial proportion of energy resources towards gynoid fat storage, to support the energetic burden of reproduction. Similarly, axial calcium accrual is favoured in females compared with males. Nutritional status is a prognostic indicator in cystic fibrosis (CF), but girls and young women are at greater risk of death despite equivalent nutritional status to males. The aim of this study was to compare fat (energy) and calcium stores (bone density) in males and females with CF over a spectrum of disease severity. Methods: Fat as % body weight (fat%) and lumbar spine (LS) and total body (TB) bone mineral density (BMD) were measured using dual absorption X-ray photometry in 127(59M) control and 101(54M) CF subjects, aged 9–25 years. An equation for predicted age at death had been determined using survival data and history of pulmonary function for the whole clinic, based on a trivariate normal model using maximum likelihood methods (1). For the CF group, a disease severity index (predicted age at death) was calculated from the derived equations according to each subjects history of pulmonary function, current age, and gender. Disease severity was classified according to percentile of predicted age at death (‘mild’ ≥75th, ‘moderate’ 25th–75th, ‘severe’ ≤25th percentile). Wt for age z-score was calculated. Serum testosterone and oestrogen were measured in males and females respectively. Fat% and LSBMD were compared between the groups using ANOVA. Results: There was an interaction between disease severity and gender: increasing disease severity was associated with greater deficits in TB (p=0.01), LSBMD (p<0.0001) and wt z-score (p=0.01) in males than females. These indices were preserved in females with severe disease compared with males (-0.36+/-0.9 vs -1.76+/-0.9, -0.88+/-1.1 vs - 3.0+/-0.9 and -0.31+/-0.91 vs -1.19+/-0.91 respectively). Fat% was higher in females as a group (p<0.0001), 25.3, 19.2, 20.9, 24.4 (SD 7.6)% for controls and those with mild, moderate and severe disease respectively, compared with 16.5, 13.6, 15.3, 15.9 (SD 7.6)% for corresponding groups in males. Testosterone was lower in males with CF (p=0.001 for comparison between the groups) but oestrogen similar to normal controls in females (p=0.75 for comparison between the groups). Conclusions: Girls and young women with CF had preserved BMD and wt z-score compared with males, and greater fat mass than males, independent of disease severity. We hypothesise that reproductive fitness favours diversion of energy resources in females to accrual of nutrient stores (fat and calcium), possibly at the expense of adaptation to the energy demands of CF disease. In contrast, males may be able to divert energy resources for support of cardiopulmonary and other functions, resulting in relatively improved prognosis. (1) Schluchter et al, Stat Med 2002;21:1271.
Subjects EX
730110 Respiratory system and diseases (incl. asthma)
111005 Mental Health Nursing
Q-Index Code EX

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Created: Thu, 23 Aug 2007, 20:43:15 EST