Treatment-related Correlates of Growth in Children With Sickle Cell Disease in the DISPLACE Cohort.
Treatment-related Correlates of Growth in Children With Sickle Cell Disease in the DISPLACE Cohort.
复制标题
DISPLACE队列中镰状细胞病儿童生长的治疗相关性
DOI：
10.1097/mph.0000000000002296
复制
发表时间：
2022-07-01
期刊：
影响因子：
--
通讯作者：
Ojesina AI
中科院分区：
文献类型：
--
作者：
Galadanci NA;Sohail M;Akinyelure OP;Kanter J;Ojesina AI
患有镰状细胞病 (SCD) 的儿童会出现生长减慢和成熟延迟。本研究调查了 DISPLACE（关注护理环境的中风预防传播和实施）队列中患有 SCD 的儿童的生长和溶血情况。该数据库包含 5,287 名儿童，其中 3,305 名儿童在五年内至少进行过两次生长测量。将体重指数转换为 z 分数 (zBMI)，分别有 19.8%、66.1%、14.2% 的儿童被分类为体重不足、正常和超重/肥胖。对生长进行多变量分析，包括变量：年龄、性别、血压、血红蛋白、网织红细胞计数、慢性红细胞输血疗法（CRCT）或羟基脲疗法（HU）。与正常 zBMI 相比，基线血红蛋白水平与较低的体重不足几率（OR 0.93，95% CI：0.86 – 0.99）以及较高的超重/肥胖几率（OR：1.26，95% CI：1.17 – 1.36）相关。 CRCT 与基线超重/肥胖相关（OR：1.85，95% CI：1.31 – 2.60）。总体而言，结果表明，在两年的时间里，无论接受何种治疗，体重不足的儿童都有所改善。然而，接受 CRCT 的儿童超重的风险较高，应密切监测。
Reduced growth and delayed maturation have been described in children with sickle cell disease (SCD). This study investigated growth and hemolysis in children with SCD in the DISPLACE (Dissemination and Implementation of Stroke Prevention Looking at the Care Environment) cohort. The database includes 5,287 children, of which, 3,305 had at least two growth measurements over a five-year period. Body mass index was converted to z-scores (zBMI), and 19.8%, 66.1%, 14.2% of children were classified as underweight, normal, and overweight/obese, respectively. Multivariable analysis of growth was conducted and included variables: age, sex, blood pressure, hemoglobin, reticulocyte count, treatment with chronic red cell transfusion therapy (CRCT) or hydroxyurea therapy (HU). Baseline hemoglobin levels were associated with the lower odds of being underweight (OR 0.93, 95% CI: 0.86 – 0.99), and higher odds of being overweight/obese (OR: 1.26, 95% CI: 1.17 – 1.36) compared with normal zBMI. CRCT was associated with being overweight/obese at baseline (OR: 1.85, 95% CI: 1.31 – 2.60). Overall, results showed that children who were underweight improved regardless of therapy over the two-year time period. However, children on CRCT are at higher risk for being overweight and should be monitored closely.