Sex-Specific Long-Term Height and Body Mass Index Trajectories of Children Diagnosed with Attention-Deficit/Hyperactivity Disorder and Treated with Stimulants

Michal Yackobovitch-Gavan, Aviva Mimouni-Bloch, Uri Gabbay, Doron Carmi, Bat El Goldstein, Lital Keinan-Boker, Stav Bloch, Joseph Meyerovitch*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To evaluate the sex-specific effects of stimulants in children with attention-deficit/hyperactivity disorder (ADHD) on body mass index (BMI) z and height z trajectories. Study design: A retrospective cohort study using the database of Israel Clalit Health Services was performed. Participants included 5- to 18-year-old insured patients with documentation of at least 2 consecutive prescriptions of stimulant drugs for ADHD. Participants were further compared with sex- and age-matched insured control patients without ADHD. Results: A total of 4561 (66% boys) participants with ADHD were included. Of these, 2151 (70% boys) had follow-up data for ≥2 years of treatment. A decline of ≥1 SD in height and BMI z score was observed in 10.1% and 13.2% of the cohort, respectively. During ≥2 years follow-up, boys had a greater decline in height z score (~0.2 SD) than girls (~0.06 SD). Boys' height z score continued to decline after 1 and ≥2 years, and girls' height z score declined after 1 year, and then stabilized. The trajectory of BMI z score of boys and girls was similar, showing a greater decline after 1 year, followed by an incline after ≥2 years. Younger age at stimulants initiation, better adherence, longer treatment duration, and lower socioeconomic status were correlated with a greater impact on growth attenuation. The non-ADHD group (n = 4561, 66% boys) had baseline height z score and BMI z score similar to those in children with ADHD before treatment initiation. Height z score and BMI z score were greater in children without ADHD compared with children with ADHD following 1 year of treatment (P <.001). Conclusions: These findings highlight the importance of growth monitoring accompanied with dietary counseling in children with ADHD treated with stimulants.

Original languageEnglish
Pages (from-to)296-304.e4
JournalJournal of Pediatrics
Volume238
DOIs
StatePublished - Nov 2021

Keywords

  • ADHD
  • BMI
  • children
  • height
  • sex
  • stimulants]]

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