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Longitudinal growth in children and adolescents with inflammatory bowel disease
H Hildebrand1, J Karlberg, B Kristiansson
1Department of Pediatrics I, University of Göteborg, Sweden.
Insights
Children with inflammatory bowel disease (IBD) experience growth issues. While ulcerative colitis patients normalize height, Crohn
Area of Science:
- Pediatric Gastroenterology
- Growth and Development Studies
- Inflammatory Bowel Disease Research
Background:
- Longitudinal growth patterns in children with inflammatory bowel disease (IBD) are crucial for understanding long-term health outcomes.
- Previous studies indicate significant growth impairment in pediatric IBD patients.
Purpose of the Study:
- To longitudinally assess weight and height changes from birth to adulthood in children diagnosed with IBD.
- To compare growth trajectories between ulcerative colitis and Crohn's disease in a pediatric cohort.
Main Methods:
- A population-based cohort of 124 children with IBD in Sweden (1983-1987) was studied.
- Weight and height were measured longitudinally from birth to adulthood.
- Growth velocity, weight-for-height, and pubertal timing were analyzed.
Main Results:
- Height growth velocity was reduced in the year preceding diagnosis for both ulcerative colitis and Crohn's disease.
- At diagnosis, weight-for-height was subnormal in both groups, and height was reduced in Crohn's disease.
- Ulcerative colitis patients normalized weight-for-height within a year and achieved normal final height; Crohn's disease patients had persistent height deficits despite improved weight-for-height and delayed puberty.
Conclusions:
- Inflammatory bowel disease significantly impacts childhood growth, with Crohn's disease having a more substantial effect on final height.
- Delayed puberty in Crohn's disease partially mitigated the negative impact on final adult height.
- Early diagnosis and treatment may influence growth outcomes in pediatric IBD.
Abstract:
Weight and height were followed longitudinally from birth to adulthood in children with inflammatory bowel disease living in a defined area of Sweden, 1983 through 1987; 124 children out of a possible 128 were studied. During the year preceding diagnosis, height growth velocity was significantly reduced in both ulcerative colitis and Crohn's disease. At the time of diagnosis, weight-for-height was subnormal in both children with ulcerative colitis (p < 0.05) and those with Crohn's disease (p < 0.001), while height was reduced only in children with Crohn's disease (p < 0.05). Weight for height was normalized within one year in ulcerative colitis, after the initiation of medical therapy. In Crohn's disease, weight-for-height improved during the years following diagnosis but height remained subnormal. Children with ulcerative colitis reached puberty at the normal time and their final heights became normal. In children with Crohn's disease, puberty was delayed (p < 0.001) and final height was reduced (p < 0.01). The impact of inflammatory bowel disease on growth was substantial, but it was smaller in this study than in many other published studies. The possible reasons for this difference include use of population-based material and a relatively short interval between the first symptoms and the start of treatment. Our findings indicate that, although final height was significantly reduced in children with Crohn's disease, delayed puberty reduced the negative effects on permanent adult height, to a certain extent compensating for the period of poor growth earlier in life.