Kherati Rida, Bansal Archana, Oleksiewicz Julia, Kadir Ahmed, Burgess Natasha, Barr Sabrina, Naik Sandhia, Croft Nicholas M, Gasparetto Marco
Queen Mary University of London Barts and The London School of Medicine and Dentistry London UK.
Department of Paediatric Gastroenterology, Clinical Research Facility, Barts Health NHS Trust The Royal London Children's Hospital London UK.
JPGN Rep. 2024 Jan 4;5(1):17-28. doi: 10.1002/jpr3.12037. eCollection 2024 Feb.
The objective of this study was to explore the correlation between paediatric Crohn's disease (CD) characteristics, bone health and growth parameters at diagnosis and follow-up.
Retrospective data was collected for 47 children aged 4-16 who were newly diagnosed with CD between January 2018 and December 2019. Mean follow-up time was 2.5 years.
Eleven (24%) children had growth delay at diagnosis, which persisted in 4 (44%) of 9 recorded children at follow-up. Of the 35 children tested, 20 (57%) had inadequate Vitamin D levels (<50 mmol/L) at diagnosis. Thirty-seven (79%) children had a dual-energy X-ray absorptiometry scan at diagnosis, with 20 of them having at least 1 low -score. Children with poorer bone mineral density and bone mineral concentration -scores for age had a younger age at diagnosis ( = .042 and = .021), more severe disease ( = .04 and = .029) and a lower BMI ( < .001) at diagnosis. Children diagnosed with CD ≥11 years had a lower-than-expected height velocity ( < .0001 and < .001). Multivariate regression analysis demonstrated an older age of diagnosis was a significant predictor of a lower height velocity at follow-up.
Disease severity and age of diagnosis are important CD-related factors that influence bone health and growth. Vitamin D is an accessible component that if optimised can improve all three factors. Monitoring and optimising each aspect systematically has the potential to enable children to achieve their bone health and growth potentials.
本研究的目的是探讨儿童克罗恩病（CD）的特征、诊断及随访时的骨骼健康与生长参数之间的相关性。
收集了2018年1月至2019年12月期间新诊断为CD的47名4至16岁儿童的回顾性数据。平均随访时间为2.5年。
11名（24%）儿童在诊断时有生长发育迟缓，在随访的9名有记录的儿童中，4名（44%）持续存在生长发育迟缓。在接受检测的35名儿童中，20名（57%）在诊断时维生素D水平不足（<50 mmol/L）。37名（79%）儿童在诊断时进行了双能X线吸收测定扫描，其中20名至少有1个低分。骨矿物质密度和骨矿物质浓度年龄评分较差的儿童在诊断时年龄较小（P = 0.042和P = 0.021），疾病更严重（P = 0.04和P = 0.029），诊断时BMI较低（P < 0.001）。诊断时年龄≥11岁的CD儿童身高增长速度低于预期（P < 0.0001和P < 0.001）。多因素回归分析表明，诊断时年龄较大是随访时身高增长速度较低的显著预测因素。
疾病严重程度和诊断年龄是影响骨骼健康和生长的重要的与CD相关的因素。维生素D是一个可调节的因素，如果进行优化，可以改善所有这三个因素。系统地监测和优化每个方面有可能使儿童发挥其骨骼健康和生长潜力。
