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Risk factors for growth retardation in children with juvenile idiopathic arthritis: a case-control study
Ying Zhang1, Liping Song1, Weihu Ma1
1Department of Pediatric, Hebei Medical University Third Hospital, 139 Ziqiang Road, Shijiazhuang City, 050051, Hebei Province, China.
Insights
Growth retardation affects over 25% of children with juvenile idiopathic arthritis (JIA). Key risk factors include longer disease duration, less exercise, and active disease, which can be used to predict outcomes.
Area of Science:
- Pediatric Rheumatology
- Growth and Development
- Clinical Pediatrics
Background:
- Juvenile idiopathic arthritis (JIA) poses significant challenges to child development.
- Growth retardation is a common complication in children diagnosed with JIA.
- Identifying risk factors is crucial for timely intervention and improved patient outcomes.
Purpose of the Study:
- To investigate factors contributing to growth retardation in juvenile idiopathic arthritis (JIA) patients.
- To identify key risk factors influencing growth outcomes in children with JIA.
- To assess the predictive value of identified risk factors for growth retardation.
Main Methods:
- Retrospective analysis of clinical data from 155 JIA patients (January 2019 - December 2022).
- Comparison of children with and without growth retardation (height Z-score < -2 SD).
- Logistic regression and ROC curve analysis to identify and assess risk factors.
Main Results:
- Growth retardation was observed in 25.81% (40/155) of JIA patients.
- Independent risk factors identified: disease duration ≥3 years, exercise <1 hr/day, glucocorticoid use, and active disease.
- Combined factors showed a high predictive value (AUC = 0.702).
Conclusions:
- High incidence of growth retardation in JIA patients.
- Disease duration, exercise, glucocorticoid treatment, and disease activity are significant contributors.
- Combined assessment of these factors enhances predictive accuracy for growth retardation in JIA.
Objective:
This study aimed to investigate the role of various factors contributing to growth retardation, including nutritional intake, disease duration, and treatment history, and further identify key risk factors that may influence growth outcomes in patients with juvenile idiopathic arthritis (JIA).
Methods:
Clinical data from 155 JIA children who were treated at our hospital between January 2019 and December 2022 were analyzed. The children were divided into the growth retardation group (n = 40) and the non-growth retardation group (n = 115) based on the height Z-score < -2 SD or not. The two groups were compared based on their baseline characteristics, disease-related factors, dietary habits, lifestyle, and family background. Logistic regression and receiver operating characteristic (ROC) curve analyses were employed to identify and assess the factors associated with growth retardation.
Results:
Out of the 155 children, 40 (25.81%) were diagnosed with growth retardation. Children with growth retardation were more likely to have a disease duration ≥ 3 years (72.50% vs. 39.13%, P < 0.001), exercise time < 1 h/per day (68.50% vs. 33.04%, P < 0.001), glucocorticoid use (65.00% vs. 34.78%, P = 0.001), and active disease activity (72.50% vs. 37.39%, P < 0.001). These factors were identified as independent risk factors for growth retardation in multivariate analysis. The area under the curve (AUC) values for these factors ranged from 0.651 to 0.676, indicating moderate predictive accuracy. When considering all these factors together, the combined model demonstrated an AUC value of 0.702, suggesting a high predictive value.
Conclusion:
The incidence of growth retardation in children with JIA is high, with factors such as disease duration, exercise time, GC treatment, clinic visits, picky eating, and disease activity contributing to its development. While each of these factors demonstrates moderate predictive value individually, their combined consideration significantly improves predictive accuracy.
Clinical Trial Number:
Not applicable.
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