Growth and weight gain in children with juvenile idiopathic arthritis: results from the ReACCh-Out cohort.
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Guzman Jaime, Kerr Tristan, Ward Leanne M, Ma Jinhui, Oen Kiem, Rosenberg Alan M, Feldman Brian M, Boire Gilles, Houghton Kristin, Dancey Paul, Scuccimarri Rosie, Bruns Alessandra, Huber Adam M, Watanabe Duffy Karen, Shiff Natalie J, Berard Roberta A, Levy Deborah M, Stringer Elizabeth, Morishita Kimberly, Johnson Nicole, Cabral David A, Larché Maggie, Petty Ross E, Laxer Ronald M, Silverman Earl, Miettunen Paivi, Chetaille Anne-Laure, Haddad Elie, Spiegel Lynn, Turvey Stuart E, Schmeling Heinrike, Lang Bianca, Ellsworth Janet, Ramsey Suzanne E, Roth Johannes, Campillo Sarah, Benseler Susanne, Chédeville Gaëlle, Schneider Rayfel, Tse Shirley M L, Bolaria Roxana, Gross Katherine, Feldman Debbie, Cameron Bonnie, Jurencak Roman, Dorval Jean, LeBlanc Claire, St Cyr Claire, Gibbon Michele, Yeung Rae S M, Duffy Ciarán M, Tucker Lori B
Аннотация
METHODS: Canadian children newly-diagnosed with JIA 2005-2010 had weight and height measurements every 6 months for 2 years, then yearly up to 5 years. These measurements were used to calculate mean age- and sex-standardized Z-scores, and estimate prevalence and cumulative incidence of growth impairments, and the impact of disease activity and corticosteroids on growth.
RESULTS: One thousand one hundred forty seven children were followed for median 35.5 months. Mean Z-scores, and the point prevalence of short stature (height < 2.5th percentile, 2.5% to 3.4%) and obesity (BMI > 95th percentile, 15.8% to 16.4%) remained unchanged in the whole cohort. Thirty-three children (2.9%) developed new-onset short stature, while 27 (2.4%) developed tall stature (>97.5th percentile). Children with systemic arthritis (n = 77) had an estimated 3-year cumulative incidence of 9.3% (95%CI: 4.3-19.7) for new-onset short stature and 34.4% (23-49.4) for obesity. Most children (81.7%) received no systemic corticosteroids, but 1 mg/Kg/day prednisone-equivalent maintained for 6 months corresponded to a drop of 0.64 height Z-scores (0.56-0.82) and an increase of 0.74 BMI Z-scores (0.56-0.92). An increase of 1 in the 10-cm physician global assessment of disease activity maintained for 6 months corresponded to a drop of 0.01 height Z-scores (0-0.02).
CONCLUSIONS: Most children in this modern JIA cohort grew and gained weight as children in the general population. About 1 in 10 children who had systemic arthritis, uncontrolled disease and/or prolonged corticosteroid use, had increased risk of growth impairment.