BACKGROUND: Short stature is a common occurrence in individuals with DMD and can be worsened by the use of glucocorticoids. This study aims to conduct a natural history investigation of height growth and the incidence of short stature in DMD patients aged 2-12 years. The study also aims to comprehensively explore the relevant factors that influence height growth in order to provide new evidence for research and clinical management of DMD growth and development.
OBJECTIVES: A retrospective, cross-sectional study was conducted at West China Second Hospital of Sichuan University from January 2022 to January 2024. 348 participants with DMD aged 2-12 attending were enrolled. Multiple linear regression were used to explore the relevant factors associated with height.
RESULTS: The 3rd, 50th, 97th percentile of the height growth curve for DMD individuals showed a retarded growth compared with Chinese healthy male population aged from 2-12 years. As shown in figure 2, children with DMD were around the same height as average children at the age of two, but the height begins to gradually fall behind after then. The range of height disperses with age, standard deviation of height varied from 5.42 at age three to 13.22 at age twelve, higher than the standard deviation of 8.5 in healthy male population at age twelve. The results of the multiple linear regression analysis indicate that the regression equation was significant (F=0.841, p<0.001). Specifically, BMI (β=-0.339, p=0.005) had a significant negative effect on height, while β-CTX (β=0.004, p=0.024) had a significant positive effect on height. These variables together accounted for 78.70% of the variance in height in DMD boys.
CONCLUSION: Children with DMD tend to have similar height to healthy population at early stages of the disease, while the height growth curve gradually deviated from normal growth curve as the progressive disease processed, even before they started taking GC. Changes in bone markers and height may have predictive value in patients with DMD, especially β-CTX.