Modan-Moses Dalit, Yaroslavsky Amit, Novikov Ilia, Segev Sharon, Toledano Anat, Miterany Edith, Stein Daniel
Pediatric Endocrinology Service, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Pediatrics. 2003 Feb;111(2):270-6. doi: 10.1542/peds.111.2.270.
To assess growth retardation in male adolescent patients who have a diagnosis of anorexia nervosa (AN) and the effect of weight restoration on catch-up growth.
Medical charts of all male adolescent AN patients (n = 12) who were admitted to the Pediatric Psychosomatic Department at the Sheba Medical Center from January 1, 1994, to December 31, 1998, were reviewed. Height and weight measurements were obtained before the onset of AN, at admission, and thereafter routinely during hospitalization and follow-up.
Eleven patients exhibited growth retardation during the course of their illness, as evident in a decrease in their height standard deviation score (SDS). The mean height SDS at the time of admission (-0.81 +/- 0.93) was significantly lower than the premorbid SDS (-0.21 +/- 0.91). Weight restoration resulted in accelerated linear growth (up to 2 cm/mo) in all patients. Positive weight gain (weight gain rate >1 kg/y) was associated with a mean height gain of 6.97 +/- 6.48 cm/y, whereas weight loss or failure to gain weight (weight gain rate <or=1 kg/y) was associated with a mean of 2.7 +/- 3.9 cm/y. This between-group difference was highly significant. Complete catch-up growth was not achieved in 9 of 12 patients. There was a trend for the mean adult final height SDS (-0.52 +/- 0.84) to be higher than the admission height SDS but lower than both the premorbid height SDS and the midparental target height SDS (-0.21 +/- 0.79).
Linear growth retardation was a prominent feature of AN in our sample of male adolescent patients, preceding, in some cases, the reported detection of the eating disorder. Weight restoration, particularly when target weight is based on the premorbid height percentile, may be associated with significant catch-up growth, but complete catch-up growth may not be achieved.
评估诊断为神经性厌食症（AN）的男性青少年患者的生长发育迟缓情况以及体重恢复对追赶生长的影响。
回顾了1994年1月1日至1998年12月31日期间入住舍巴医疗中心儿科身心科的所有男性青少年AN患者（n = 12）的病历。在AN发病前、入院时以及此后住院和随访期间定期测量身高和体重。
11例患者在病程中出现生长发育迟缓，身高标准差得分（SDS）下降明显。入院时的平均身高SDS（-0.81±0.93）显著低于病前SDS（-0.21±0.91）。体重恢复使所有患者的线性生长加速（每月可达2厘米）。体重正增长（体重增加率>1千克/年）与平均身高增加6.97±6.48厘米/年相关，而体重减轻或体重未增加（体重增加率≤1千克/年）与平均身高增加2.7±3.9厘米/年相关。两组之间的差异非常显著。12例患者中有9例未实现完全追赶生长。成年最终身高的平均SDS（-0.52±0.84）有高于入院时身高SDS的趋势，但低于病前身高SDS和父母身高中位数目标SDS（-0.21±0.79）。
在我们的男性青少年患者样本中，线性生长迟缓是AN的一个突出特征，在某些情况下，早于所报告的饮食失调的发现。体重恢复，特别是当目标体重基于病前身高百分位数时，可能与显著的追赶生长相关，但可能无法实现完全追赶生长。
