Sternum Length and Rib Cage Dimensions Compared with Bodily Proportions in Adults with Cystic Fibrosis

Overview

Journal Can Respir J

Publisher Wiley

Specialty Pulmonary Medicine

Date 2012 Jun 9

PMID 22679612

Authors

Louis-Philippe Laurin

Vincent Jobin

Francois Bellemare

Affiliations

Soon will be listed here.

Abstract

Background: A greater structural expansion of the rib cage in females compared with males has been described in cystic fibrosis (CF) patients; however, conflicting data exist as to whether an elongation of the bony ribs and sternum contributes to this expansion.

Objectives: To compare height-adjusted anthropometric measures and sternum length between a group of normal subjects and a group of CF patients of both sexes.

Methods: Anthropometric measurements including body weight, height, upper and lower limb lengths, biacromial distance and pelvic width were measured in the standing position in 30 CF patients (13 males) and 28 normal subjects (14 males). Body surface measurements of anterior-posterior and lateral diameters of the rib cage at functional residual capacity, and sternum length were also obtained.

Results: Compared with normal subjects, CF patients had lower body weight, shorter standing height and shorter height-adjusted upper and lower limb lengths. Rib cage diameters were greater in CF patients than in normal subjects of either sex, but height-adjusted sternum length was not different.

Conclusion: Significant differences in bodily proportions were found between normal subjects and CF patients, suggesting a differential growth pattern for the trunk and limbs. However, increased rib cage dimensions with lung hyperinflation and airway obstruction was not associated with an elongation of the sternum.

References

ASHLEY G . The relationship between the pattern of ossification and the definitive shape of the mesosternum in man. J Anat. 1956; 90(1):87-105. PMC: 1244824. View

Bellemare J, Cordeau M, Leblanc P, Bellemare F . Thoracic dimensions at maximum lung inflation in normal subjects and in patients with obstructive and restrictive lung diseases. Chest. 2001; 119(2):376-86. DOI: 10.1378/chest.119.2.376. View

Tanner J, Whitehouse R, Hughes P, Carter B . Relative importance of growth hormone and sex steroids for the growth at puberty of trunk length, limb length, and muscle width in growth hormone-deficient children. J Pediatr. 1976; 89(6):1000-8. DOI: 10.1016/s0022-3476(76)80620-8. View

STAMM S, DOCTER J . CHEST MEASUREMENTS AS AN AID IN THE DIAGNOSIS OF CYSTIC FIBROSIS. Dis Chest. 1965; 47:98-101. DOI: 10.1378/chest.47.1.98. View

Lai H, Kosorok M, Sondel S, Chen S, FitzSimmons S, Green C . 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; 132(3 Pt 1):478-85. DOI: 10.1016/s0022-3476(98)70024-1. View

Binder G . Short stature due to SHOX deficiency: genotype, phenotype, and therapy. Horm Res Paediatr. 2011; 75(2):81-9. DOI: 10.1159/000324105. View

DEMUTH G, HOWATT W, Hill B . THE GROWTH OF LUNG FUNCTION. Pediatrics. 1965; 35:SUPPL:159-218. View

Bellemare F, Fuamba T, Bourgeault A . Sexual dimorphism of human ribs. Respir Physiol Neurobiol. 2006; 150(2-3):233-9. DOI: 10.1016/j.resp.2005.04.002. View

Schnabel D, Grasemann C, Staab D, Wollmann H, Ratjen F . A multicenter, randomized, double-blind, placebo-controlled trial to evaluate the metabolic and respiratory effects of growth hormone in children with cystic fibrosis. Pediatrics. 2007; 119(6):e1230-8. DOI: 10.1542/peds.2006-2783. View

10.

Guignon I, Cassart M, Gevenois P, Knoop C, Antoine M, Yernault J . Persistent hyperinflation after heart-lung transplantation for cystic fibrosis. Am J Respir Crit Care Med. 1995; 151(2 Pt 1):534-40. DOI: 10.1164/ajrccm.151.2.7842217. View

11.

Mullis P, Di Silvio L, Brook C . Short stature in a patient with cystic fibrosis caused by a 6.7-kb human growth hormone gene deletion. Horm Res. 1991; 36(1-2):4-8. DOI: 10.1159/000182097. View

12.

Patel L, Dixon M, David T . Growth and growth charts in cystic fibrosis. J R Soc Med. 2003; 96 Suppl 43:35-41. PMC: 1308786. View

13.

Wong M, Carter D . Mechanical stress and morphogenetic endochondral ossification of the sternum. J Bone Joint Surg Am. 1988; 70(7):992-1000. View

14.

Bellemare F, Jeanneret A . Sex differences in thoracic adaptation to pulmonary hyperinflation in cystic fibrosis. Eur Respir J. 2006; 29(1):98-107. DOI: 10.1183/09031936.00045606. View

15.

Rosenfeld M, Davis R, Fitzsimmons S, Pepe M, Ramsey B . Gender gap in cystic fibrosis mortality. Am J Epidemiol. 1997; 145(9):794-803. DOI: 10.1093/oxfordjournals.aje.a009172. View

16.

DAVIS P . The gender gap in cystic fibrosis survival. J Gend Specif Med. 2001; 2(2):47-51. View

17.

Thomas A, Supinski G, Kelsen S . Changes in chest wall structure and elasticity in elastase-induced emphysema. J Appl Physiol (1985). 1986; 61(5):1821-9. DOI: 10.1152/jappl.1986.61.5.1821. View