title: Corticosteroid Treatment and Growth Patterns in Ambulatory Males with Duchenne Muscular Dystrophy.
abstract: To evaluate growth patterns of ambulatory males with Duchenne muscular dystrophy (DMD) treated with corticosteroids compared with ambulatory, steroid-naïve males with DMD and age-matched unaffected general-population males and to test associations between growth and steroid treatment patterns among treated males.
  
  
  
  Using data from the Muscular Dystrophy Surveillance, Tracking, and Research Network, we identified a total of 1768 height, 2246 weight, and 1755 body mass index (BMI) measurements between age 2 and 12 years for 324 ambulatory males who were treated with corticosteroids for at least 6 months. Growth curve comparisons and linear mixed-effects modeling, adjusted for race/ethnicity and birth year, were used to evaluate growth and steroid treatment patterns (age at initiation, dosing interval, duration, cumulative dose).
  
  
  
  Growth curves for ambulatory males treated with corticosteroids showed significantly shorter stature, heavier weight, and greater BMI compared with ambulatory, steroid-naïve males with DMD and general-population US males. Adjusted linear mixed-effects models for ambulatory males treated with corticosteroids showed that earlier initiation, daily dosing, longer duration, and greater dosages predicted shorter stature with prednisone. Longer duration and greater dosages predicted shorter stature for deflazacort. Daily prednisone dosing predicted lighter weight, but longer duration, and greater dosages predicted heavier weight. Early initiation, less than daily dosing, longer duration, and greater doses predicted greater BMIs. Deflazacort predicted shorter stature, but lighter weight, compared with prednisone.
  
  
  
  Prolonged steroid use is significantly associated with short stature and heavier weight. Growth alterations associated with steroid treatment should be considered when making treatment decisions for males with DMD.
authors.affiliation: Colorado School of Public Health, Aurora, CO. Electronic address: Molly.Lamb@ucdenver.edu.
authors.forename: Molly M
authors.initials: MM
authors.lastname: Lamb
authors.affiliation: Colorado School of Public Health, Aurora, CO; University of Mississippi Medical Center, Jackson, MS.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: West
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Lijing
authors.initials: L
authors.lastname: Ouyang
authors.affiliation: Children's Hospital Colorado, Aurora, CO.
authors.forename: Michele
authors.initials: M
authors.lastname: Yang
authors.affiliation: Children's Hospital Colorado, Aurora, CO.
authors.forename: David
authors.initials: D
authors.lastname: Weitzenkamp
authors.affiliation: Colorado School of Public Health, Aurora, CO.
authors.forename: Katherine
authors.initials: K
authors.lastname: James
authors.affiliation: University of Rochester, Rochester, NY.
authors.forename: Emma
authors.initials: E
authors.lastname: Ciafaloni
authors.affiliation: University of Rochester, Rochester, NY.
authors.forename: Shree
authors.initials: S
authors.lastname: Pandya
authors.affiliation: Colorado School of Public Health, Aurora, CO.
authors.forename: Carolyn
authors.initials: C
authors.lastname: DiGuiseppi
mesh_terms: D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects*; D011282:Pregnenediones / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D005938:Glucocorticoids; D011282:Pregnenediones; C021988:deflazacort; D011241:Prednisone
keywords: BMI; height; weight