Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia.
Med J Aust. 2013 Jan 21;198(1):29-32. doi: 10.5694/mja12.10931.
To investigate the growth and pubertal attainment of boys with attention deficit hyperactivity disorder (ADHD) on stimulant medication.
DESIGN, SETTING AND PARTICIPANTS: Longitudinal study of boys aged 12.00-15.99 years at recruitment in 2005-2011, with stimulant-treated ADHD for at least 3 years, attending three paediatric practices (subjects), compared with longitudinal data from 174 boys from the Nepean longitudinal study (controls).
Subjects' growth parameters before treatment were compared with controls aged 7 or 8 years; growth parameters and longitudinal changes on treatment to ages 12.00-13.99 and 14.00-15.99 years were compared with controls reviewed at 13 and 15 years of age, respectively. The subjects' pubertal staging and height velocity were related to their treatment history.
Sixty-five subjects were recruited; mean duration of treatment was 6.3 ± 1.9 years. At baseline, their growth parameters were not significantly different from those of the controls after adjusting for age. Compared with the controls, after adjusting for current age and baseline growth parameter z score, subjects aged 12.00-13.99 years had significantly lower weight and body mass index (P < 0.01), and those aged 14.00-15.99 years had significantly lower height and weight (P < 0.05). At 12.00-13.99 years of age, the subjects were comparable to the controls in their pubertal development adjusted for age, but those aged 14.00-15.99 years reported significant delay (mean Tanner stage, 3.6 for subjects v 4.0 for controls; P < 0.05). The dose of medication was inversely correlated with the height velocity from baseline to 14.00-15.99 years of age (P < 0.05).
Prolonged treatment (more than 3 years) with stimulant medication was associated with a slower rate of physical development during puberty. To maintain adequate height velocity during puberty, we recommend keeping the dose as low as possible.
研究接受兴奋剂药物治疗的注意缺陷多动障碍（ADHD）男孩的生长和青春期发育情况。
设计、地点和参与者：2005-2011 年期间，招募了年龄在 12.00-15.99 岁的男孩，进行了纵向研究，这些男孩在招募时接受了至少 3 年的兴奋剂治疗 ADHD，并在三个儿科诊所就诊（研究对象），并与来自 Nepean 纵向研究的 174 名男孩的纵向数据（对照组）进行了比较。
治疗前研究对象的生长参数与对照组（7 岁或 8 岁）进行比较；治疗后至 12.00-13.99 岁和 14.00-15.99 岁时的生长参数和纵向变化与对照组（分别在 13 岁和 15 岁时进行了评估）进行了比较。研究对象的青春期分期和身高速度与其治疗史有关。
共招募了 65 名研究对象，平均治疗时间为 6.3±1.9 年。在基线时，经过年龄调整后，他们的生长参数与对照组无显著差异。与对照组相比，在调整当前年龄和基线生长参数 z 分数后，12.00-13.99 岁的研究对象体重和体重指数显著较低（P<0.01），14.00-15.99 岁的研究对象身高和体重显著较低（P<0.05）。在 12.00-13.99 岁时，研究对象的青春期发育与对照组的年龄调整后相匹配，但 14.00-15.99 岁的研究对象报告青春期发育明显延迟（平均 Tanner 分期，研究对象为 3.6，对照组为 4.0；P<0.05）。药物剂量与从基线到 14.00-15.99 岁的身高速度呈负相关（P<0.05）。
长期（超过 3 年）接受兴奋剂药物治疗与青春期期间身体发育速度较慢有关。为了在青春期保持足够的身高速度，我们建议将剂量保持在尽可能低的水平。
