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Long-Term Skeletal Disproportion in Childhood-Onset Crohn's Disease
Avril Mason1, Konstantinos Gerasimidis2, Jelena Iljuhhina2
1Developmental Endocrinology Research Group, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Royal Hospital for Children, Glasgow, United Kingdom.
Insights
Adults with Crohn's disease (CD) originating in childhood experience more significant short stature, particularly men, potentially due to impaired spinal growth. This contrasts with adult-onset CD patients.
Area of Science:
- Pediatric Gastroenterology
- Endocrinology
- Orthopedics
Background:
- Crohn's disease (CD) is an inflammatory bowel disease with unclear long-term skeletal implications.
- Skeletal disproportion in adulthood related to CD requires further investigation.
Purpose of the Study:
- To investigate skeletal disproportion in adults with childhood-onset (CO-CD) versus adult-onset (AO-CD) Crohn's disease.
- To determine if CD impacts height, sitting height, and leg length differently based on onset age.
Main Methods:
- Anthropometric measurements (Height, Sitting Height, Leg Length) were collected.
- Study included 44 children with CO-CD, 23 adults with CO-CD, and 26 adults with AO-CD.
- Statistical analysis compared skeletal parameters between groups and against normative data.
Main Results:
- Adults with CO-CD exhibited significantly lower median Height standard deviation scores (SDS) compared to AO-CD patients.
- Men with CO-CD showed significantly lower median Sitting Height SDS than a normal population.
- The typical association between leg length and Sitting Height SDS was absent in adults with CO-CD.
Conclusions:
- Childhood-onset Crohn's disease is associated with pronounced short stature in adulthood, especially in males.
- Impaired spinal growth may contribute to the observed short stature in CO-CD patients.
- Skeletal disproportion is a notable complication of pediatric Crohn's disease.
Background:
It is unclear whether Crohn's disease (CD) is associated with skeletal disproportion in adulthood.
Methods:
Height (Ht), sitting height (SHt) and leg length were studied in 44 children (male: 22), 23 adults (male: 10) with childhood-onset (CO) CD and 26 adults (male: 9) with adult-onset (AO) CD with a median (range) age of 13.7 (10, 17.3), 21.5 (18, 32) and 31.0 (22, 40) years, respectively.
Results:
Adults with CO-CD had a median Ht standard deviation score (SDS) of -0.9 (-2.3, 0.0) compared to 0.6 (-0.8, 1.0) in those with AO-CD (p < 0.05). Compared to a normal population, men, but not women, with CO-CD also had lower median SHt SDS at -1.1 (2.5, -0.5) (p < 0.05). The expected positive association that is normally found between leg length and SHt SDS was not evident in the adults with CO-CD.
Conclusion:
Short stature in adults with CO-CD is more pronounced in men and may be associated with poor spinal growth.
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