初潮后的生长发育在儿科炎症性肠病中的变化。

Growth After Menarche in Pediatric Inflammatory Bowel Disease.

机构信息

From the Section of Adult and Pediatric Endocrinology, University of Chicago, Chicago, IL.

the Section of Pediatric Gastroenterology, Hepatology and Nutrition, University of Chicago Comer Children's Hospital, Chicago, IL.

出版信息

J Pediatr Gastroenterol Nutr. 2023 Feb 1;76(2):183-190. doi: 10.1097/MPG.0000000000003667. Epub 2022 Dec 1.

DOI:10.1097/MPG.0000000000003667

PMID:36705699

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9889107/

Abstract

OBJECTIVES

Growth impairment in pediatric patients with pediatric onset inflammatory bowel disease (IBD) is multifactorial. Reports on the effect of age at menarche on adult stature in this population are limited. This study investigated the impact of age at menarche, disease-associated factors, and mid-parental height on growth from menarche to final height (FHt) in pediatric patients with Crohn disease (CD) and ulcerative colitis (UC) and IBD unclassified (IBD-U).

METHODS

Subjects were enrolled from a prospectively maintained pediatric IBD database when IBD preceded menarche and dates of menarche and FHt measurements were recorded.

RESULTS

One hundred forty-six patients: CD 112 and UC 30/IBD-U 4. Mean age (years) at diagnosis (10.9 vs 10.1), menarche (14.4 vs 14.0), and FHt (19.6 vs 19.7). CD and UC/IBD-U patients showed significant association between Chronological age (CA) at menarche and FHt (cm, P < 0.001) but not FHt z score (FHt-Z) < -1.0 (P = 0.42). FHt-Z < -2.0 occurred in only 5 patients. Growth impairment (FHt-Z < -1.0) was associated with surgery before menarche (P = 0.03), jejunal disease (P = 0.003), low mid-parental height z score (MPH-Z) (P < 0.001), hospitalization for CD (P = 0.03) but not UC, recurrent corticosteroid, or anti-tumor necrosis factor alpha (anti-TNFα) therapy.

CONCLUSIONS

Early age of menarche was associated with greater potential for linear growth to FHt but not FHt-Z (P < 0.05). Surgery before menarche, jejunal disease, hospitalization for CD, low MPH, and weight z score were associated with FHt-Z < -1.0.

摘要

目的

儿科发病的炎症性肠病（IBD）患儿存在生长受损，其病因复杂。关于初潮年龄对该人群成年终身高的影响的报道有限。本研究旨在调查初潮年龄、与疾病相关的因素以及双亲身高对克罗恩病（CD）、溃疡性结肠炎（UC）和未分类 IBD（IBD-U）患儿从初潮至最终身高（FHt）的生长的影响。

方法

当 IBD 先于初潮且记录了初潮和 FHt 测量日期时，从前瞻性维持的儿科 IBD 数据库中招募受试者。

结果

共纳入 146 例患者：CD112 例，UC30 例，IBD-U4 例。诊断时年龄（岁）（10.9 比 10.1）、初潮年龄（14.4 比 14.0）和 FHt（19.6 比 19.7）。CD 和 UC/IBD-U 患者的初潮时的实际年龄（CA）与 FHt（cm，P < 0.001）之间存在显著关联，但 FHt-Z< -1.0（P = 0.42）无显著关联。仅 5 例患者的 FHt-Z< -2.0。初潮前手术（P = 0.03）、空肠疾病（P = 0.003）、双亲身高 z 评分（MPH-Z）低（P < 0.001）、因 CD 住院（P = 0.03）与生长受损（FHt-Z< -1.0）相关，但与 UC、反复使用皮质类固醇或抗肿瘤坏死因子-α（anti-TNFα）治疗无关。