Longitudinal Studies of Growth & Pubertal Progress in Adolescents with Inflammatory Bowel Disease

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 624-646-Growth: Clinical Trials & Observational Studies
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-644
Avril Mason*1, Salma Malik1, Martin McMillan1, Jane McNeilly2, John Bishop3, Paraic McGrogan1, Richard K Russell4 and S Faisal Ahmed5
1RHSC Glasgow, Glasgow, United Kingdom, 2RHSC Glagow, Glasgow, United Kingdom, 3Starship Children's hospital, Auckland, New Zealand, 4RHSC Glasgow, Glagow, United Kingdom, 5Royal Hosp for Sick Children, Glasgow Scotland, United Kingdom
Background:Puberty and growth may be affected in inflammatory bowel disease (IBD) but the extent of these effects in adolescents is unclear.

Aims:To determine the impact of IBD on pubertal status and pubertal growth.

Methods:Single-center, prospective study over 12 months in 45 adolescents (boys,23) with Crohn’s Disease (CD) and 18 (boys,12) with ulcerative colitis (UC) with a median age of 13.4yrs (range,10,16.6). Assessment included details of disease and anthropometry at 0 and 12 months and biochemical markers of growth and puberty at 0 months.

Results:The median HtDiag SDS, Ht0 SDS and Ht12 SDS for the overall groups were similar to the normal population, however, on sub-group analysis, the boys with CD were significantly shorter at 12 months (p=0.048). Individually, 10/45 (22%) adolescents with CD cases had one or more parameters of growth affected: 7 had HtDiagSDS <-2 and 6 had Ht0SDS and Ht12SDS <-2. The median change in (Δ) HtSDS from T0 to T12 for the overall group was 0.06(-0.48, 0.56).

The median difference between the chronological age (CA) and bone age (BA) at 0 months for the whole group was 0.3 (-2.5, 3.0) and not different from the normal population, however there was a significant difference when the CD group was compared with the normal population (p=0.049). None of the adolescents remained prepubertal beyond the age at which 97% of population would be expected to enter Genital Stage 2. One boy with CD did not enter Genital Stage 4 by the age 97% of normal male population would have expected to enter Tanner Stage 4 and one girl did not enter Breast Stage 4 by the age 97% of normal male population would have expected to enter this stage.

Median IGF1 SDS for the overall group was -0.43 (-5.81,2.62) and was significantly different from the normal population (p=0.03) but not between sex and disease–specific subgroups. Median IGFBP3 SDS for the overall group was 0.43 (-1.93,2.66) and significantly higher than the normal population (p<0.0001) and remained significant when the CD group were compared to the normal population (p=0.001). IGF1 SDS and IGFBP3 SDS showed a significant association with Ht0 SDS in the whole group (r,0.365; p=0.005 and r,-0.318; p=0.015).

Median urinary LH:FSH, salivary testosterone (boys), and plasma INSL3 (boys) were not significantly different from sex and puberty matched healthy controls.

Conclusion: Disorders of pubertal growth are more likely to occur in CD.  Clinically this should prompt the need for detailed biochemical evaluation.  Achieving disease control may be important in attaining normal growth during puberty.

Nothing to Disclose: AM, SM, MM, JM, JB, PM, RKR, SFA

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm