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成骨不全症患儿的标准化生长图表。

Standardized growth charts for children with osteogenesis imperfecta.

机构信息

Shriners Hospital for Children - Canada, McGill University, Montreal, QC, Canada.

Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada.

出版信息

Pediatr Res. 2023 Sep;94(3):1075-1082. doi: 10.1038/s41390-023-02550-0. Epub 2023 Mar 15.

Abstract

BACKGROUND

Osteogenesis imperfecta (OI) is associated with short stature, which is mild, severe and moderate in OI types I, III and IV, respectively. Standardized OI type- and sex-specific growth charts across all pediatric ages do not exist.

METHODS

We assessed 573 individuals with OI (type I, III or IV), each with at least one height measurement between ages 3 months and 20 years (total 6523 observations). Analogous to the Centers for Disease Control pediatric growth charts, we generated OI type- and sex-specific growth charts for infants (ages 3-36 months) as well as children and adolescents (ages 2-20 years). Growth curves were fitted to the data using the LMS method and percentiles were smoothed.

RESULTS

Age was associated with a decline in height z-scores (p < 0.001 for all OI types), which was more pronounced in females. Height multiplier curves were produced to predict adult height in children with OI. Among individuals with OI type I, those with COL1A1 pathogenic variants leading to haploinsufficiency were taller than those with COL1A1 or COL1A2 pathogenic variants not leading to haploinsufficiency.

CONCLUSION

Our standardized OI type- and sex-specific growth charts can be used to assess the growth of individuals with OI from infancy to adulthood.

IMPACT

Standardized osteogenesis imperfecta (OI) type- and sex-specific growth charts across all pediatric ages do not exist. Our study is the first to generate OI type- and sex-specific growth charts across all pediatric ages. Our height multiplier curves can be utilized to predict adult height in children with OI.

摘要

背景

成骨不全症(OI)与身材矮小有关,OI 类型 I、III 和 IV 分别表现为轻度、重度和中度身材矮小。目前尚无适用于所有儿科年龄的标准化 OI 型和性别特异性生长图表。

方法

我们评估了 573 名 OI(I 型、III 型或 IV 型)患者,每名患者至少有一次 3 个月至 20 岁之间的身高测量值(总计 6523 次观察)。类似于疾病控制与预防中心的儿科生长图表,我们为婴儿(3-36 个月)以及儿童和青少年(2-20 岁)生成了 OI 型和性别特异性生长图表。使用 LMS 方法拟合数据,并对百分位数进行平滑处理。

结果

年龄与身高 z 分数的下降有关(所有 OI 类型的 p 值均<0.001),女性更为明显。我们生成了身高倍增曲线,以预测 OI 儿童的成年身高。在 I 型 OI 患者中,COL1A1 致病性变异导致杂合不足的患者比 COL1A1 或 COL1A2 致病性变异不导致杂合不足的患者更高。

结论

我们的标准化 OI 型和性别特异性生长图表可用于评估从婴儿期到成年期的 OI 患者的生长情况。

影响

目前尚无适用于所有儿科年龄的标准化 OI 型和性别特异性生长图表。我们的研究首次生成了适用于所有儿科年龄的 OI 型和性别特异性生长图表。我们的身高倍增曲线可用于预测 OI 儿童的成年身高。

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