Endocrine Abstracts

Background: Delayed puberty and related problems with growth and body image in Crohn’s disease (CD) and ulcerative colitis (UC) have rarely been quantified.

Methods: A longitudinal prospective observational study of children with IBD who had anthropometric and puberty data at 0 and 6 months. Of 50 recruited, there were 15 boys (CDM) and 20 girls (CDF) with CD and ten boys (UCM) and five girls (UCF) with UC. The four groups had a median age at 0 months of 13.4, 14, 13.4 and 13.2 years respectively.

Puberty: Self-reporting performed at 0 and 6 months was compared to the normal reference population to assess for delay in age at onset, Age at G/B1, and progress, Age at G/B3. Two morning salivary testosterone (SalT) samples were collected on 2 days at 0 and 6 months in CDM and UCM and compared to pubertal status and the adult male reference range.

Growth: Height at 0 (Ht0) and Ht at 6 months (Ht6) and height velocity (HV; 0–6 months) were converted to SDS adjusted for pubertal stage (HVPA) and expressed as median (range).

Body Image: Assessed using the IMPACT 3 questionnaire.

Results: The median age of B1 was 11.2 (10, 12.2) and G1 was 11.2 years (10, 11.9) compared to a normal reference population for entry to B2 of 11.2 (9.1, 13.2) and G2 of 12 years (9.7, 14.2). The median age at B3 was 14.1 (11.6, 15.1) and G3 was 13.8 years (10.9, 15) compared to a normal reference population for entry to B4 of 13.2 (10.8, 15.6) and G4 of 13.8 years (11.7, 15.8). In boys, median SalT was <25 pmol/l (<25, 32) in G1, 57 pmol/l (<25, 193) in G2/3 and 228 pmol/l (190, 294) in G4/5 compared to the adult male reference of 216–1370 pmol/l. In G2/3, SalT was higher than G1 (P=0.05) and lower than G4/5 (P<0.0001). Median Ht0 was −0.15 (−2.6, 0.5), −0.25 (−2.5, 2.1), −0.2 (−1.7, 2.7), and 0.07 (−1.8, 0.4) and Ht6 was −0.23 (−2.8, 0.5), −0.27 (−2.6, 2.1), −0.07 (−1.7, 2.5), and 0.31 (−1.8, 0.4) for CDM, CDF, UCM and UCF respectively. Median HVPA was −0.75 (−7.3, 3.4), −2.3 (−5.1, 5.5), 1.63 (−4.3, 3.3), and 0.4 (−2.4, 4.5) for CDM, CDF, UCM and UCF respectively. In CDF, HVPA was significantly lower than 0 (P=0.003). Median body image domain score, using IMPACT 3, showed a significant association with Ht0 and Ht6 (r, −0.31; P=0.03).

Conclusion: As a group, disorders of puberty and pubertal growth are more likely to occur in CD, which may have an affect on stature and body image.