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Assessment of Child Anthropometry in a Large Epidemiologic Study
09:36

Assessment of Child Anthropometry in a Large Epidemiologic Study

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Thiopurines are negatively associated with anthropometric parameters in pediatric Crohn's disease

Neera Gupta1, Robert H Lustig2, Cewin Chao3

  • 1Division of Gastroenterology and Nutrition, Department of Pediatrics, Weill Cornell Medicine, New York, NY 10021, United States. neg9020@med.cornell.edu.

World Journal of Gastroenterology
|May 16, 2018
PubMed

Insights

In pediatric Crohn's disease (CD), thiopurine medications showed poor efficacy, while infliximab may have sex-specific effects on growth. Further longitudinal studies are needed to confirm these findings in pediatric CD patients.

Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Growth and Development Studies

Background:

  • Pediatric Crohn's disease (CD) significantly impacts growth and development.
  • Understanding the relationship between treatments, biomarkers, and anthropometric parameters is crucial for managing pediatric CD.
  • Current knowledge gaps exist regarding the efficacy of specific medications and the influence of serum biomarkers on growth in this population.

Purpose of the Study:

  • To analyze the distribution of anthropometric parameter (AP)-z-scores in pediatric CD patients.
  • To investigate the associations between various medications and serum biomarkers with AP-z-scores.
  • To evaluate the efficacy of thiopurines and potential sex-specific growth responses to infliximab.

Main Methods:

  • A cross-sectional study involving pediatric CD patients under 21 years old.
  • Calculation and comparison of AP-z-scores based on chronological age (CA) and bone age (BA).
  • Linear regression analysis to determine associations between medications/serum biomarkers and AP-z-scores (n=82 for CA, n=49 for BA).

Main Results:

  • Bone age z-scores for triceps skinfold, subscapular skinfold, and mid-arm circumference were higher than chronological age z-scores.
  • Adalimumab and methotrexate were positively associated with subscapular skinfold and BMI z-scores, while azathioprine/6-mercaptopurine showed negative associations with several anthropometric measures.
  • Infliximab demonstrated a potential sex difference in height z-scores, with females showing higher scores. Specific biomarkers like hemoglobin, ESR, CRP, albumin, and IGF-1 also showed significant associations with anthropometric parameters.

Conclusions:

  • Results indicate limited efficacy of thiopurine medications in pediatric CD.
  • A possible sex-specific difference in statural growth response to infliximab treatment was observed.
  • Further prospective longitudinal studies are necessary to validate these findings and guide treatment strategies.
Abstract

Keywords:
Azathioprine/6-mercaptopurineBiologicsInflammatory bowel diseaseNutrition

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