Department of Pediatrics, Assuta Ashdod University Hospital, Ashdod.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva.
J Pediatr Gastroenterol Nutr. 2021 Aug 1;73(2):223-230. doi: 10.1097/MPG.0000000000003072.
The impact of pediatric-onset inflammatory bowel disease (IBD) on growth is debated. We aimed to investigate the effect of IBD on anthropometric measures at young adulthood.
Children diagnosed with Crohn disease (CD) or ulcerative colitis (UC) (2005-2019) were identified in a national database along with matched non-IBD controls.
Overall, 2229 IBD cases (68% CD) were matched to 4338 controls. Only females with CD differed in final height from controls (z scores: -0.37 ± 1.09 vs -0.25 ± 1.06, respectively; P = 0.01), corresponding to a mean difference of 0.7 ± 0.2 cm (all females) and 1.2 ± 0.3 cm in females diagnosed <14 years (P = 0.02). Final height was reduced in both sexes according to adjusted mean height difference analysis (-0.43 cm, 95% confidence interval -0.85 to -0.02; P = 0.04). This difference increased in patients with CD who underwent abdominal surgery (-0.91 cm, 95% confidence interval -1.39 to -0.42; P = 0.01). The proportion of patients with CD achieving final height z scores of -1 and zero differed significantly from controls for both males (71.1% and 34.8% vs 79.1% and 43.0%, respectively; P < 0.001) and females (67.7% and 30.4% vs 79.6%, and 43.3%, respectively; P < 0.001). Patients treated with anti-tumor necrosis factor agents during growth potential had similar height improvement to other regimens. Predominantly, patients with CD were leaner, with a greater proportion of subjects with underweight, compared with controls.
In pediatric-onset IBD, absolute final height was modestly affected by females with CD. Nevertheless, greater proportions of both sexes with early diagnosis of CD failed to achieve normal final height, compared with controls.
小儿发病的炎症性肠病（IBD）对生长的影响存在争议。我们旨在研究 IBD 对成年早期人体测量指标的影响。
在全国数据库中，我们确定了患有克罗恩病（CD）或溃疡性结肠炎（UC）（2005-2019 年）的儿童病例，并与非 IBD 对照病例相匹配。
总体而言，2229 例 IBD 病例（68%为 CD）与 4338 例对照病例相匹配。仅女性 CD 患者的最终身高与对照组不同（身高 z 评分：-0.37±1.09 与-0.25±1.06，分别；P=0.01），这相当于所有女性的平均差异为 0.7±0.2cm 和 14 岁以下诊断的女性为 1.2±0.3cm（P=0.02）。根据调整后的平均身高差异分析，两性的最终身高均降低（-0.43cm，95%置信区间-0.85 至-0.02；P=0.04）。接受腹部手术的 CD 患者的差值增加（-0.91cm，95%置信区间-1.39 至-0.42；P=0.01）。男性和女性中，CD 患者的最终身高 z 评分达到-1 和 0 的比例与对照组有显著差异（分别为 71.1%和 34.8%与 79.1%和 43.0%；P<0.001）和女性（分别为 67.7%和 30.4%与 79.6%和 43.3%；P<0.001）。在生长潜能期间接受抗肿瘤坏死因子治疗的患者的身高改善与其他治疗方案相似。主要的是，与对照组相比，CD 患者更瘦，体重不足的患者比例更大。
在小儿发病的 IBD 中，女性 CD 患者的最终身高受到一定程度的影响。然而，与对照组相比，更多的男女患者在 CD 早期诊断时未能达到正常的最终身高。
