Hildebrand H, Karlberg J, Kristiansson B
Department of Pediatrics I, University of Göteborg, Sweden.
J Pediatr Gastroenterol Nutr. 1994 Feb;18(2):165-73. doi: 10.1097/00005176-199402000-00008.
Weight and height were followed longitudinally from birth to adulthood in children with inflammatory bowel disease living in a defined area of Sweden, 1983 through 1987; 124 children out of a possible 128 were studied. During the year preceding diagnosis, height growth velocity was significantly reduced in both ulcerative colitis and Crohn's disease. At the time of diagnosis, weight-for-height was subnormal in both children with ulcerative colitis (p < 0.05) and those with Crohn's disease (p < 0.001), while height was reduced only in children with Crohn's disease (p < 0.05). Weight for height was normalized within one year in ulcerative colitis, after the initiation of medical therapy. In Crohn's disease, weight-for-height improved during the years following diagnosis but height remained subnormal. Children with ulcerative colitis reached puberty at the normal time and their final heights became normal. In children with Crohn's disease, puberty was delayed (p < 0.001) and final height was reduced (p < 0.01). The impact of inflammatory bowel disease on growth was substantial, but it was smaller in this study than in many other published studies. The possible reasons for this difference include use of population-based material and a relatively short interval between the first symptoms and the start of treatment. Our findings indicate that, although final height was significantly reduced in children with Crohn's disease, delayed puberty reduced the negative effects on permanent adult height, to a certain extent compensating for the period of poor growth earlier in life.
1983年至1987年期间，对生活在瑞典某特定地区的炎症性肠病患儿从出生到成年进行了纵向的体重和身高跟踪研究；在可能的128名儿童中，对124名儿童进行了研究。在诊断前的一年中，溃疡性结肠炎和克罗恩病患儿的身高增长速度均显著降低。在诊断时，溃疡性结肠炎患儿（p<0.05）和克罗恩病患儿（p<0.001）的身高体重比均低于正常水平，而只有克罗恩病患儿的身高降低（p<0.05）。在溃疡性结肠炎患儿开始药物治疗后的一年内，身高体重比恢复正常。在克罗恩病中，诊断后的几年里身高体重比有所改善，但身高仍低于正常水平。溃疡性结肠炎患儿按时进入青春期，最终身高也正常。克罗恩病患儿青春期延迟（p<0.001），最终身高降低（p<0.01）。炎症性肠病对生长的影响很大，但在本研究中比许多其他已发表的研究中要小。造成这种差异的可能原因包括使用基于人群的资料以及首次出现症状到开始治疗之间的间隔相对较短。我们的研究结果表明，虽然克罗恩病患儿的最终身高显著降低，但青春期延迟在一定程度上减少了对成年后永久身高的负面影响，弥补了生命早期生长不良的时期。
