Growth patterns in children with sickle cell anemia during puberty.
BACKGROUND
Previous studies of children with homozygous sickle cell anemia (SCA) show impaired growth and maturation. The correlation of this suboptimal growth with metabolic and hematological factors during puberty is poorly understood.


METHODS
We studied a group of pre-adolescent children with SCA (19 males, 14 females) and healthy controls (16 males, 15 females) matched for race, sex, body size, and pubertal development. Height, weight, body mass index (BMI), and body composition changes were longitudinally assessed over a 2-year period and compared between the groups and with Z scores based on US growth charts. These changes were correlated with hemoglobin (Hgb) concentration and with energy expenditure (EE) measured using indirect whole-room calorimetry.


RESULTS
Children with SCA progressed through puberty slower than control children. While, after 2 years, pubertal males with SCA were shorter, their annual increases in weight were not different from controls. The mean fat free mass (FFM) increments were significantly less in males and females with SCA than in control children. In males with SCA, growth in height declined over time and was significantly slower than in matched controls (P < 0.05).


CONCLUSIONS
Growth delays were present during puberty in children with SCA. Decreased growth velocity in children with SCA was independently associated with decreased Hgb concentration and increased total EE.
Rhodes
Melissa
M
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA.
Akohoue
Sylvie A
SA
Shankar
Sadhna M
SM
Fleming
Irma
I
Qi An
Angel
A
Yu
Chung
C
Acra
Sari
S
Buchowski
Maciej S
MS
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D001827:Body Height; D015992:Body Mass Index; D015519:Bone Density; D002648:Child; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D011627:Puberty / Q000502:physiology*