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Correlation between digital clubbing and pulmonary function in cystic fibrosis
Author(s) -
Nakamura Craig T.,
Ng Gladys Y.,
Paton James Y.,
Keens Thomas G.,
Witmer James C.,
BautistaBolduc Daisy,
Woo Marlyn S.
Publication year - 2002
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.10082
Subject(s) - medicine , cystic fibrosis , gastroenterology , pulmonary function testing , respiratory disease , hypoxemia , lung
The correlation between digital clubbing and certain pulmonary function derangements (hypoxemia and FEV 1 ) was previously described. However, the relationship between digital clubbing and other measures of pulmonary function or the presence of liver disease in patients with cystic fibrosis (CF) is poorly defined. Hence we compared the digital clubbing index (CI: ratio of distal phalangeal depth to interphalangeal depth) of 100 patients with CF (43 males, 57 females; mean age, 15.7 ± 7.3 years) with that of 100 age‐ and gender‐matched healthy controls. Digital clubbing was defined as a CI ≥ 1.00 (mean + 2.6 SD; 99% of normal subjects). The CI and its relationship to pulmonary function and to liver disease was then evaluated in the CF patients. Digital clubbing was present in 75/100 (75%) of CF patients but was absent in all controls ( P < 0.0001). In CF patients, CI was inversely correlated with PaO 2 (r = −0.555; P < 0.001), FEV 1 (r = −0.499; P < 0.001), and FEF 25–75% (r = −0.404; P < 0.001), and was positively correlated with RV (r = 0.285; P < 0.05) and the slope of phase 3 of single‐breath nitrogen washout (SP3N 2 ) (r = 0.532; P < 0.01). There was no significant correlation between CI and age (r = 0.020; P = 0.84), TLC (r = −0.097; P = 0.34), PaCO 2 (r = 0.167; P = 0.10), or history of liver disease ( P = 0.08). We conclude that in CF, the degree of digital clubbing is related to degree of hypoxemia, airways obstruction, hyperinflation, and nonuniformity of ventilation. Pediatr Pulmonol. 2002; 33:332–338. © 2002 Wiley‐Liss, Inc.