OBJECTIVE  To investigate the related factors of height growth disorder caused by long-term glucocorticoid use in children with glomerular disease, and to explore the possible causes and intervention strategies.

METHODS  Data of children with glomerular disease who were treated for continuously glucocorticoids for at least 6 months in Children’s Hospital, Zhejiang University School of Medicine, were retrospectively collected, including gender, height, weight, diagnosis, age of onset, recurrence, glucocorticoids category, usage and dosage, starting and stopping time, combined use of immunosuppressive drugs, etc. The average annual height increase(ΔH) was calculated. SPSS V 23.0 software was used to analyze the factors that have significant influence on ΔH by univariate and multivariate analysis.

RESULTS A total of 121 children with glomerular disease were enrolled in this study. The average duration of glucocorticoid use was 21.7 months, and the average annual cumulative dose was 159.5 mg·kg⁻¹ according to prednisone. The height at onset and end of the glucocorticoids were (112.8±17.9) and (123.2±15.6) cm, respectively, and the ΔH was (5.0±1.7) cm (0.0−10.4 cm). There was an overall decrease of 0.6 SD in height grade at the end, and a quarter of the children were 2 SD shorter than the same age and sex, which suggested that the use of hormones may lead to impaired growth in height. Further univariate and multivariate analysis showed that, age of onset and average annual glucocorticoids cumulative dose were important factors influencing ΔH(with significant negative correlation). The older the age of onset, the smaller the ΔH was. The ΔH(change in height) for those who developed the condition before age 3 and before age 7 was 5.44 cm and 4.99 cm, respectively. When the glucocorticoids dosage was less than 100 mg·kg⁻¹ per year(0.27 mg·kg⁻¹·d⁻¹), ΔH was more than 6.0 cm, and when the glucocorticoids dosage was more than 300 mg·kg⁻¹ per year(0.82 mg·kg⁻¹·d⁻¹), ΔH was only less than 2.9 cm.

CONCLUSION The effect of long-term use of glucocorticoids on the height growth of children should not be ignored , especially in children with younger onset age and higher average annual glucocorticoids cumulative dose. Optimization of glucocorticoid therapy may be can reduce the related adverse reactions.