March 17, 2020
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Childhood-onset IBD leads to shorter adult height

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Patients diagnosed with inflammatory bowel disease in childhood attain a lower adult height than their peers without IBD, according to study results.

Natalia Mouratidou, MD, of Astrid Lindgren Children’s Hospital in Sweden, and colleagues wrote that growth impairment and pubertal delay are common complications in patients with childhood-onset IBD, but studies of adult height outcomes in this population have varied.

“The etiology of growth impairment in IBD is multifactorial,” they wrote. “Undernourishment and direct effects of pro-inflammatory cytokines seem to be important explanatory factors.”

Researchers identified 4,201 individuals diagnosed with childhood-onset IBD between 1990 and 2014, including 1,640 with Crohn’s disease, 2,201 with ulcerative colitis and 360 with unclassified IBD.

Compared with reference individuals, patients with IBD attained a lower adult height (adjusted mean height difference [AMHD] = –0.9 cm; 95 % CI, –1.1 to –0.7). They also attained a lower height than their healthy siblings (AMHD = –0.8 cm; 95% CI, –1 to –0.6).

Investigators found that shorter adult height was seen more often in patients with pre-pubertal disease onset (AMHD = –1.6; 95% CI, –2 to –1.2), as well as in patients with a more severe disease course (AMHD = –1.9 cm, 95% CI, –2.4 to –1.4).

Mouratidou and colleagues found that patients with CD were slightly shorter (–0.6) than patients with UC (–1.3), while 5% of patients with CD and 4.3% of patients with UC were classified as growth impaired compared with 2.5% of matched reference individuals (OR = 2.42; 95% CI, 1.85-3.17 and OR = 1.74; 95% CI, 1.36-2.22, respectively).

“Patients with childhood-onset IBD on average attained a statistically significant lower final adult height and were more often growth retarded than general population reference individuals or the IBD patients’ healthy siblings,” they concluded. “However, most patients with childhood-onset IBD seemed to attain a final adult height that was only modestly lower than that of their healthy peers and siblings. Subsets of patients characterized by markers of severe inflammation had a stronger association with reduced final adult height, which calls for improved care for these children.” – by Alex Young

Disclosure: Mouratidou reports being supported by the Crown Princess Louisa’s Memory Fund. Please see the full study for all other authors’ relevant financial disclosures.