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首页> 美国卫生研究院文献>Lippincott Williams Wilkins Open Access >Stimulant medication effects on growth and bone age in children with attention-deficit/hyperactivity disorder: a prospective cohort study
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Stimulant medication effects on growth and bone age in children with attention-deficit/hyperactivity disorder: a prospective cohort study

机译：注意力缺陷/多动障碍儿童的兴奋性药物治疗对生长和骨龄的影响：一项前瞻性队列研究

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Stimulant medication is known to cause transient weight loss and slowing down of growth, but whether it delays physical maturation is unclear. We studied growth and bone age over the first 3 years of treatment in children with attention-deficit/hyperactivity disorder (patients) compared with healthy siblings (controls). Bone age was estimated blindly by two independent radiologists using Tanner and Whitehouse version 3. Dexamphetamine or methylphenidate was titrated and continued when clinically indicated. Forty out of 73 patients, together with 22 controls, completed the study. There were no significant growth differences between the two groups at baseline. Despite slower growth on treatment [5.1 cm/year, 95% confidence interval (CI): 4.7–5.5, vs. 6.3 cm/year, 95% CI: 5.7–6.8, P=0.002; and 2.7 kg/year, 95% CI: 2.1–3.3, vs. 4.4 kg/year, 95% CI: 3.5–5.3, P=0.005], the patients showed no significant maturational delay (RUS score: 49 U/year, 95% CI: 44–55, vs. 55 U/year, 95% CI: 47–63, P=0.27). A subgroup of patients underwent serial biochemistry and dual-energy X-ray absorptiometry, recording a significant reduction in fat (5.61±3.56–4.22±3.09 kg, P<0.001) and leptin (3.88±2.87–2.57±1.94 ng/ml, P=0.017). The pattern of change in height z-score over time was modified by the dose of medication (P for interaction=0.024). We found no medication effect on the rate of maturation, which was instead predicted by baseline leptin (P=0.035 controlling for age and sex).
机译：已知刺激性药物会导致短暂的体重减轻和生长减慢，但是尚不清楚它是否会延迟身体成熟。与健康的同胞（对照组）相比，我们研究了患有注意力缺陷/多动障碍（患者）的儿童在治疗的前3年的生长和骨龄。两位独立的放射线医师使用Tanner和Whitehouse版本3盲目估计了骨龄。在临床上需要时，滴定了地塞米明或哌醋甲酯，并继续使用。 73名患者中的40名以及22名对照完成了研究。基线时两组之间没有显着的生长差异。尽管治疗的增长较慢[5.1？cm /年，95％置信区间（CI）：4.7-5.5，而6.3？cm /年，95％CI：5.7-6.8，P = 0.002；和2.7 kg /年，95％CI：2.1–3.3，而4.4 kg /年，95％CI：3.5–5.3，P = 0.005]，患者无明显的成熟延迟（RUS评分：49 U /年， 95％CI：44–55，而55 U /年，95％CI：47–63，P = 0.27）。一小组患者进行了系列生化和双能X射线吸收测定，脂肪（5.61±3.56–4.22±3.09 kg，P <0.001）和瘦素（3.88±2.87–2.57±1.94 ng / ml）显着降低， P = 0.017）。高度z分数随时间的变化模式通过药物剂量进行了修改（相互作用的P = 0.024）。我们发现药物对成熟率没有影响，而是由基线瘦素预测的（控制年龄和性别的P = 0.035）。

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