Preventing early, prolonged vitamin E deficiency: an opportunity for better cognitive outcomes via early diagnosis through neonatal screening - 21/08/11
, HuiChuan J. Lai, PhD, RD, Anita Laxova, BS, Kathleen M. Zaremba, MPH, Michael R. Kosorok, PhD, Jeff A. Douglas, PhD, Michael J. Rock, MD, Mark L. Splaingard, MD, Philip M. Farrell, MD, PhD
Reprint requests: Rebecca Koscik, PhD, Assistant Scientist, Department of Biostatistics and Medical Informatics, K6/422 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792.Abstract |
Objective |
To evaluate whether early diagnosis of cystic fibrosis (CF) through newborn screening (NBS) and early vitamin E status are associated with cognitive function.
Study design |
We assessed cognitive function for 71 children without meconium ileus (ages 7.3-16.9 years) enrolled in the screened (S) or control (C) group of the Wisconsin CF Neonatal Screening Project. The Test of Cognitive Skills, 2nd edition generated the cognitive skills index (CSI; mean = 100, SD = 16). Vitamin E deficiency at diagnosis was defined as plasma alpha-tocopherol (⍺-T) below 300 μg/dL (<300E). Primary analyses evaluated CSI scores across the 4 levels of group (S or C) by using ⍺-T status (<300E or >300E) with analysis of covariance.
Results |
After adjusting for covariates, CSI in the C<300E group was significantly lower than each of the other groups (C>300E, S<300E, and S>300E; P < .05). The highest proportion of CSI scores >84 occurred in the C<300E group (41%). Patients in this group also had the lowest mean head circumference z-scores at diagnosis.
Conclusions |
Our results show that prolonged ⍺-T deficiency in infancy is associated with lower subsequent cognitive performance. Thus, diagnosis via NBS may benefit the cognitive development of children with CF, particularly in those prone to vitamin E deficiency during infancy.
Le texte complet de cet article est disponible en PDF.Mots-clés : ⍺-T, ANCOVA, ANOVA, C, CF, CSI, GEE, MI, PI, RCT, S, SES, TCS/2
Plan
| Supported by the (grants DK 34108, DK 02891, M01 RR03186 and M01 RR00058) and Cystic Fibrosis Foundation (grant A001-5-010). |
Vol 147 - N° 3S
P. S51-S56 - septembre 2005 Retour au numéro
Article précédent
- The Influence of Newborn Screening for Cystic Fibrosis on Pulmonary Outcomes in New South Wales
- Karen O. McKay, Donna L. Waters, Kevin J. Gaskin
- The Survival Advantage of Patients with Cystic Fibrosis Diagnosed Through Neonatal Screening: Evidence from the United States Cystic Fibrosis Foundation Registry Data
- HuiChuan J. Lai, Yu Cheng, Philip M. Farrell
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