O-009 Effects of Disease Activity and anti-TNF Therapy Upon Skeletal Maturation and Linear Growth in a Prospective Pediatric IBD Cohort
Notice bibliographique
Résumé
Linear growth impairment is a well recognized feature of Crohn’s Disease (CD), although defining it is challenging. Its presence at diagnosis can be indicative of the duration of unrecognized disease, whilst patterns post-diagnosis are reflective of treatment and treatment efficacy. Over the past decade, the awareness of IBD in the pediatric community has improved, as have the treatment options. AIM: (1) To examine the utility of Mid-parental Height and Skeletal Maturity in the assessment of growth impairment; (2) to review pre-and post diagnostic linear growth patterns in pre-pubertal children diagnosed with CD during the era of anti-TNF therapy. All patients diagnosed with IBD who were Tanner Stage I at diagnosis and would be regularly followed at the recruiting centre were eligible for this study. Patients were recruited sequentially from Sept 2007 to Sept 2009. Height potential was calculated based on the established “mid-parental-height” formula. Left Wrist Radiographs were obtained on all patients at baseline and after 2 years follow-up, and skeletal maturity estimated by a single experienced Endocrinologist. Linear growth, medication exposure and disease activity were collected at regular intervals for a minimum of 3 years. Height Z-scores were calculated using the CDC reference data. Two hundred eight patients (64% Male, 70% CD) were recruited. Predicted Ht-Z scores based on mid-parental height data were normally distributed (mean −0.02, SD 0.84). However, the group’s true mean Ht-Z score at diagnosis was reduced (mean −0.45, SD 1.0) as was their skeletal maturity (mean deficit 0.6 years, SD 1.5 years). Bone age delay correlated well with Ht-Z score deficit (r = 0.6, P < 0.001). Growth deficits were greater in CD than UC patients (Mean Ht-z deficit −0.55 versus −0.14, P = 0.012). In CD patients, disease activity during 2 years of follow-up, substantially impacted ongoing linear growth and skeletal maturity (none/minimal disease activity: median delta bone age 21 months; >minimal disease activity: median delta bone age 13 months; P = 0.013). Patients receiving anti-TNF therapy within the first year of diagnosis experienced a substantial increase in Ht-z score compared to patients who did not receive such therapy (Mean Delta Ht-Z score 0.31 versus 0.09, P = 0.009). Linear growth impairment remains a diagnostic feature of children with CD, although the degree of impairment in the recent decade appears less than in prior decades. Mid-parental heights appear a robust method of predicting an individual patient’s growth potential, and relative changes in skeletal maturity another method of confirming ongoing status. Effective disease control remains paramount in the management of children with CD and impaired linear growth. (This research was supported by a CCFA Senior Award, PI: Dr LA Denson).
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».