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Impact of pediatric inflammatory bowel disease on linear growth: Data from a national cohort study in Saudi Arabia
Mohammad I El Mouzan1, Mohammad A Al Mofarreh, Omar I Saadah
1Department of Pediatrics, Head, Pediatric Inflammatory Bowel Disease Research Group, Member of Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University, Riyadh, Saudi Arabia.
Insights
Linear growth impairment (LGI) affects children with inflammatory bowel disease (IBD). This study found LGI prevalence in Saudi children with IBD, noting higher rates in early-onset Crohn's disease and older ulcerative colitis patients.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Growth and Development Studies
Background:
- Linear growth impairment (LGI) is a significant clinical feature in pediatric inflammatory bowel disease (IBD).
- Understanding the prevalence and patterns of LGI in specific populations is crucial for timely intervention.
Purpose of the Study:
- To determine the impact of IBD on the linear growth of children in the Kingdom of Saudi Arabia (KSA).
- To define the prevalence of LGI in pediatric IBD patients within KSA.
Main Methods:
- A multicenter retrospective study analyzed data from 374 newly diagnosed pediatric IBD patients (2003-2012).
- Linear growth impairment was defined as length/height for age <-2 standard deviations using WHO references.
- Chi-square tests were employed to assess statistical significance (P < 0.05).
Main Results:
- The overall prevalence of LGI was 26% in pediatric IBD patients (28% in Crohn's disease [CD], 21% in ulcerative colitis [UC]).
- LGI was significantly more common in CD patients under 10 years old (P = 0.010).
- In UC patients, LGI was more prevalent in older children (P = 0.011).
Conclusions:
- The prevalence of LGI in Saudi pediatric IBD patients aligns with global reports.
- Early-onset CD (<10 years) and older UC patients showed higher LGI rates, emphasizing the need for growth monitoring.
- Further prospective studies are required to evaluate IBD's impact on growth velocity, puberty, and adult stature.
Background/Aim:
Linear growth impairment (LGI) is one of the most important features peculiar to children with inflammatory bowel disease (IBD). The aim of this report is to define the impact of IBD on the linear growth of children in the Kingdom of Saudi Arabia (KSA).
Setting And Design:
Multicenter retrospective study.
Patients And Methods:
Data from a cohort of newly- diagnosed children with IBD from 2003 to 2012 were analyzed retrospectively. The diagnosis of IBD was confirmed in accordance with the published criteria. Length/height for age was measured at diagnosis. The World Health Organization (WHO) reference was used and LGI was defined by length/height for age <-2 standard deviation. Chi-square test was used to test the significance of estimates and a P < 0.05 was considered significant.
Results:
There were 374 children from 0.33 to 16 years of age, including 119 ulcerative colitis (UC) (32%), and 255 Crohn's disease (CD) (68%) patients. The prevalence of LGI was 26%, 28%, and 21% in IBD, CD, and UC, respectively. In children below 10 years, LGI was significantly more common in CD (P = 0.010), while in UC children, it was more common in older children (P = 0.011).
Conclusion:
This study demonstrates a prevalence of LGI consistent with that reported in the literature, but higher in CD children with early onset (<10 years) and in older children with UC, underscoring the importance of monitoring growth in children with IBD in the Saudi population. Prospective studies are needed to define the impact of IBD on growth velocity, puberty, and final adult stature.
