Malnutrition and linear growth limitation in children with Crohn’s disease (CD) can be caused by low caloric intake, chronic inflammation, malabsorption, and inhibition of growth-promoting hormones. Researchers looked at clinical, serologic, and genetic data to see if there were any risk factors for poor anthropometrics in CD at the time of diagnosis.
The RISK Stratification Project enlisted 772 children newly diagnosed with CD, an inflammatory phenotype, in order to investigate the characteristics linked with anthropometric impairment. Demographics, growth characteristics, illness site, serologic and immunologic markers, and disease severity were all obtained. Genome-wide association analysis of genetic variants linked to inflammatory bowel disease was carried out. Anthropometrics were linked to clinical, serologic, and genetic factors using regression analysis.
There were 59 children with a height z-score of smaller than or equal to 2, 126 with a weight z-score smaller than or equal to 2, and 156 with a body mass index z-score of smaller than or equal to 2. Hypoalbuminemia (P = 0.0052), high granulocyte-macrophage colony-stimulating factor autoantibodies (P = 0.0110), and elevated CBir flagellin antibodies (P = 0.0117) were all related to linear growth impairment. Female sex, hypoalbuminemia, and thrombocytosis were related to poor weight growth. Hypoalbuminemia and thrombocytosis were connected with malnutrition. Children with moderate or severe illness weighed less (P = 0.02 and P = 1.16×10−6, respectively) and had lower body mass index z scores (P = 2.7 × 10−3 and P = 1.01 × 10−6, respectively) than children with quiescent or mild disease. There was no link found between having impaired anthropometrics and the age of diagnosis, Tanner stage, or location of the illness. There was no evidence of a genome-wide connection between the genetic variations and the serologic variables or anthropometric measures.
This is the largest research of its kind, assessing growth in treatment-naive children with CD, an inflammatory phenotype. It is the first research to examine the genetic causes of growth impairment using genome-wide sequencing. Autoantibodies to granulocyte-macrophage colony-stimulating factor and CBir antibodies are more likely to be increased in children with growth problems. Future research should look at the connection between genetic polymorphisms, pathologic immune responses, and the molecular processes that control growth.