Endocrine Abstracts

Background: Puberty is understood to be commonly effected in adolescents with Crohn’s Disease (CD) and ulcerative colitis (UC). However, the extent of this effect and related problems with growth, have rarely been quantified.

Objective: To determine the impact of CD and UC on pubertal growth.

Methods: Retrospective study of 148 children with IBD (casenotes available, 135) who fulfilled the criteria for describing growth spurt parameters (91): CD-M(30); CD-F(11); UC-M(14) and UC-F(12) had median age at diagnosis of 12.8, 11.6, 11.6 and 10.8 years.

Height at diagnosis (HAD) and height at peak height velocity (HPHV), converted to SDS, defined Size; age at PHV (APHV) defined Tempo; and PHV, converted to SDS adjusted for pubertal stage, defined Velocity of the growth spurt. The median interval between height measurements was 0.4 years. Results were expressed as median (range).

C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, alkaline phosphatase levels, haematocrit and platelet counts were compared using 1 year cumulative data prior to timing of population mean APHV, with delay in APHV.

Results: A statistically significant negative impact on 2 parameters, HAD (P=0.001) and APHV (P=0.001), was seen in the CD-M group as compared to the normal population. Individually, 8/30 CD-M cases had one or more parameter affected: 2 subjects had HADSDS <−2, 3 subjects had HPHVSDS <−2, 3 subjects had an APHV >2 years above population mean, and 2 subjects had a PHVSDS <−2. Median ESR showed a significant association with delay in APHV in the whole group (r=0.329; P=0.018).

Conclusion: As a group, disorders of the pubertal growth spurt are more likely to occur in CDM. Achieving disease control may be important in timely progression through puberty.