Growth Trajectories in Stimulant Treated Children and Adolescents: A Qualitative Review of the Literature from Comprehensive Datasets and Registries.
Growth Trajectories in Stimulant Treated Children and Adolescents: A Qualitative Review of the Literature from Comprehensive Datasets and Registries.
复制标题
接受兴奋剂治疗的儿童和青少年的生长轨迹：对综合数据集和登记文献的定性回顾。
DOI：
10.1089/cap.2023.0054
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发表时间：
2023
影响因子：
1.9
通讯作者：
Faraone,StephenV
中科院分区：
文献类型：
--
作者：
HuttVater,Chloe;Biederman,Joseph;DiSalvo,Maura;O'Connor,Hannah;Parker,Haley;Woodworth,KYvonne;Wozniak,Janet;Faraone,StephenV
目的：用兴奋剂治疗注意缺陷多动障碍(ADHD)已被证明是安全和有效的，但仍有人担心其可能对生长轨迹的不利影响。方法：利用PubMed和QicINFO检索2023年2月8日之前发表的有关儿童ADHD兴奋剂治疗相关生长发育的文献。结果：在最初确定的1070篇文章中，12篇符合全部纳入标准。样本大小从157到163,820名青年不等。在检查身高的10篇文章中，有7篇发现身高显著下降与慢性兴奋剂治疗有关，在2项研究中，随着时间的推移，身高恢复正常。三篇文章没有发现兴奋剂治疗和身高之间的显著联系。在兴奋剂治疗的累积持续时间和剂量与成人身高之间没有明确的关联。所有检查体重的文章和8篇检查身体质量指数(BMI)的文章中有6篇发现，最初显着下降，然后趋于正常化，然后随着时间的推移而增加。服用兴奋剂的时间越长，体重和BMI显著降低的可能性越大。刺激剂剂量对体重和BMI的影响大多较弱，临床意义不显著。大多数研究发现，兴奋剂治疗开始时的年龄与身高、体重或BMI的变化之间没有显著的联系。大多数研究没有发现与生长参数有关的性别效应。结论：这一生态信息性样本的综述揭示了刺激剂治疗对生长轨迹的影响主要是微小的和短暂的。对于大多数患有ADHD的年轻人来说，这些影响似乎在临床上微不足道，他们从童年到青春期和成年都接受了刺激性治疗。
Objective:Attention-deficit/hyperactivity disorder (ADHD) treatment with stimulant products has been shown to be safe and effective; however, there are remaining concerns about their possible adverse effects on growth trajectories. We conducted a systematic review of the extant literature derived from ecologically valid databases and registries to assess the body of knowledge about the effects of stimulants on growth trajectories in naturalistic samples.Methods:Using PubMed and PsycINFO, we searched for articles published before February 8, 2023 that focused on growth findings associated with stimulant treatment in pediatric ADHD from comprehensive datasets derived from naturalistic population studies.Results:Of the 1070 articles initially identified, 12 met all inclusion criteria. Sample sizes ranged from 157 to 163,820 youths. Seven of 10 articles examining height found significant decreases in height associated with chronic stimulant treatment that normalized over time in 2 studies. Three articles found no significant association between stimulant treatment and height. No clear associations were identified between cumulative duration and dose of stimulant treatment and adult height. All articles examining weight and six of eight articles examining body mass index (BMI) found significant initial decreases that tended to normalize then increase over time. Longer duration of stimulant medication use was predominantly associated with significant weight and BMI reductions. The effects of stimulant dose on weight and BMI were mostly weak and clinically insignificant. Most studies found no significant association between age at start of stimulant treatment and change in height, weight, or BMI. Most studies did not find significant sex effects in relation to growth parameters.Conclusions:This review of ecologically informative samples revealed that the effects of stimulant treatment on growth trajectories are mainly small and transient. These effects seem to be clinically insignificant for most youth with ADHD who receive stimulant treatment from childhood onto adolescence and adulthood.