Impact of Inflammatory Bowel Disease on Pubertal Growth

Abstract

Background: Puberty is thought to be commonly affected in adolescents with inflammatory bowel disease (IBD). Aims: To determine the impact of Crohn’s disease (CD) and ulcerative colitis (UC) on the pubertal growth spurt. Methods: Retrospective study of 30 boys with CD (CD-M), 11 girls with CD (CD-F), 14 boys with UC (UC-M) and 12 girls with UC (UC-F). Pubertal growth was assessed by calculating peak height velocity SDS (PHV SDS), height SDS at diagnosis (Ht_Diag) and height SDS at PHV (Ht_PHV) and age at PHV (Age_PHV). Systemic markers of disease activity were also collected. Results: Altered parameters of pubertal growth were observed in the CD groups compared to the normal population: in the CD-M group, median Ht_Diag was –0.56 (p = 0.001) and median Age_PHV was 14.45 years (p = 0.004), and in the CD-F group, median Ht_Diag was –1.14 (p = 0.007) and Ht_PHV was –0.79 (p = 0.039). Individually, 8/30 CD-M cases had one or more parameter affected: 2 boys had Ht_Diag<–2, 3 boys had Ht_PHV <–2, 2 boys had an Age_PHV >2 years above population mean, and 2 boys had a PHV SDS <–2. In the whole group, Age_PHV showed an association with erythrocyte sedimentation rate (r = 0.4; p = 0.005) and an inverse association with BMI (r = 0.4; p = 0.001). Conclusion: Disorders of pubertal growth are more likely to occur in CD and, particularly, in boys.