Gupta N¹, Lustig RH², Andrews H³, Sylvester F⁴, Keljo D⁵, Goyal A⁶, Gokhale R⁷, Patel AS⁸, Guthery S⁹, Leu CS¹⁰. Inflamm Bowel Dis. 2020 Mar 19. pii: izaa023. doi: 10.1093/ibd/izaa023. [Epub ahead of print]

Author information

1 Department of Pediatrics, Weill Cornell Medicine, New York, NY.

2 Division of Endocrinology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA.

3 Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, NY.

4 Division of Pediatric Gastroenterology, University of North Carolina at Chapel Hill, Chapel Hill, NC.

5 Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.

6 Division of Gastroenterology, Hepatology and Nutrition, Children's Mercy Kansas City, Kansas City, MI.

7 Section of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Chicago Comer Children's Hospital, Chicago, IL.

8 Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX.

9 Division of Gastroenterology, Hepatology, and Nutrition, Primary Children's Hospital and the University of Utah, Salt Lake City, UT.

10 Department of Biostatistics, Columbia University Medical Center, New York City, NY.

Abstract

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.