Introduction to and Screening Visit Results of the Multicenter Pediatric Crohn's Disease Growth Study
Neera Gupta1, Robert H Lustig2, Howard Andrews3
1Department of Pediatrics, Weill Cornell Medicine, New York, NY.
Insights
Pediatric Crohn's disease (CD) patients show sex-specific growth differences. Males exhibit lower standardized height gain, while females experience delayed puberty, impacting bone age and height Z scores.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Growth and Development
Background:
- Statural growth impairment is more prevalent in males with Crohn's disease (CD).
- Understanding sex-based differences in growth is crucial for managing pediatric CD.
- This study investigates growth patterns in a contemporary cohort of pediatric CD patients.
Purpose of the Study:
- To assess sex differences in height Z score differences and bone age (BA) Z scores in pediatric CD patients.
- To characterize the age of menarche in females with CD.
- To inform the ongoing multicenter longitudinal Growth Study.
Main Methods:
- Recruited pediatric CD patients (females aged 5-13, males aged 6-15) for a screening visit.
- Calculated height Z scores based on chronological age (CA) and bone age (BA).
- Analyzed height Z score differences and BA Z scores, and determined the median age of menarche.
Main Results:
- The absolute mean height Z score difference was significantly greater in females (0.8) than males (0.3).
- Females had a significantly lower mean BA Z score (-1.0) compared to males (-0.2).
- The median chronological age at menarche was 13.6 years.
Conclusions:
- Data suggest lower standardized height gain in males with skeletal maturation in CD.
- Delayed puberty is common in females with CD.
- Further investigation is ongoing in the Growth Study.
Background:
Statural growth impairment is more common in males with Crohn's disease (CD). We assessed sex differences in height Z score differences and bone age (BA) Z scores and characterized age of menarche in a novel contemporary cohort of pediatric CD patients undergoing screening for enrollment in the multicenter longitudinal Growth Study.
Methods:
Crohn's disease patients (females with chronological age [CA] 5 years and older and younger than 14 years; males with CA 6 years and older and younger than 16 years) participated in a screening visit for the Growth Study. Height BA-Z scores are height Z scores calculated based on BA. Height CA-Z scores are height Z scores calculated based on CA. The height Z score difference equals height CA-Z score minus height BA-Z score.
Results:
One hundred seventy-one patients (60% male) qualified for this analysis. Mean CA was 12.2 years. Mean height CA-Z score was -0.4, and mean height BA-Z score was 0.4 in females. Mean height CA-Z score was -0.1, and mean height BA-Z score was 0.2 in males. The absolute value of the mean height Z score difference was significantly greater in females (0.8) than males (0.3; P = 0.005). The mean BA-Z score in females (-1.0) was significantly lower than in males (-0.2; P = 0.002). The median CA at menarche was 13.6 (95% CI, 12.6-14.6) years.
Conclusions:
Our screening visit data suggest that standardized height gain is lower in males with skeletal maturation and delayed puberty is common in females in CD. We are investigating these findings in the ongoing Growth Study.
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