Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva, Israel,
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva, Israel.
Digestion. 2020;101(6):674-682. doi: 10.1159/000501924. Epub 2019 Sep 13.
Growth impairment is common in children with inflammatory bowel diseases (IBD). However, the magnitude of short stature at adulthood is not well characterized. We aimed to determine the prevalence and predictors of growth impairment at diagnosis and adulthood in children with IBD.
Height z-scores at diagnosis of IBD and at adulthood among 291 children with Crohn's disease (CD) and 125 with ulcerative colitis (UC) were retrieved retrospectively and compared to matched controls. Growth impairment at diagnosis was defined as height z-score for age less than or equal to -1 and short stature at adulthood as less than or equal to -2.
Mean height z-score at adulthood in subjects with CD or UC was significantly different from controls although mean height did differ in males only (CD 172.3 cm ± 6.7, UC 172.7 cm ± 5.3, controls: 174.2 cm ± 7.3, p = 0.003 and p = 0.047, respectively). Diagnosis prior to final stage of puberty and male gender were risk factors for being short statured at adulthood in CD (mean difference [MD] 2.5, p = 0.013 and MD 6.25, p = 0.001, respectively) and UC (MD 4.9, p = 0.011 and MD 3.3, p = 0.034, respectively).
Increased proportion of pediatric-onset IBD patients has growth impairment at adulthood. Male gender and diagnosis prior to puberty were found to impose risk for reduced adult height in both diseases.
炎症性肠病(IBD)患儿常出现生长障碍。然而,其成年后身材矮小的程度尚不清楚。本研究旨在确定 IBD 患儿在诊断时和成年时生长障碍的发生率及其预测因素。
回顾性检索 291 例克罗恩病(CD)患儿和 125 例溃疡性结肠炎(UC)患儿的 IBD 诊断时和成年时的身高 z 评分,并与匹配的对照组进行比较。诊断时生长障碍定义为年龄身高 z 评分≤-1,成年时身材矮小定义为身高 z 评分≤-2。
CD 或 UC 患儿的成年时平均身高 z 评分明显低于对照组,但仅男性的平均身高存在差异(CD:172.3 cm±6.7,UC:172.7 cm±5.3,对照组:174.2 cm±7.3,p=0.003 和 p=0.047)。青春期前诊断和男性是 CD(MD 2.5,p=0.013 和 MD 6.25,p=0.001)和 UC(MD 4.9,p=0.011 和 MD 3.3,p=0.034)成年后身材矮小的危险因素。
越来越多的儿科 IBD 患者成年后存在生长障碍。男性和青春期前诊断被发现会增加两种疾病成年后身高降低的风险。