Multicenter study on long-term growth in patients with phenylketonuria

Abstract Introduction Most of the studies on PKU have focused on the neurological development of patients. Studies regarding the physical development usually cover a short period of time, do not include dietary information, and results are contradictory. The aim of this study is to determine whether...

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Main Authors: S. Stanescu, A. Belanger-Quintana, J. C. Rocha, M. F. Almeida, K. Ahring, K. Dokoupil, A. M. Lammardo, E. van Dam, A. Muriel, A. MacDonald, on behalf of the ENEP group
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Orphanet Journal of Rare Diseases
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Online Access:https://doi.org/10.1186/s13023-025-03946-3
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author S. Stanescu
A. Belanger-Quintana
J. C. Rocha
M. F. Almeida
K. Ahring
K. Dokoupil
A. M. Lammardo
E. van Dam
A. Muriel
A. MacDonald
on behalf of the ENEP group
author_facet S. Stanescu
A. Belanger-Quintana
J. C. Rocha
M. F. Almeida
K. Ahring
K. Dokoupil
A. M. Lammardo
E. van Dam
A. Muriel
A. MacDonald
on behalf of the ENEP group
author_sort S. Stanescu
collection DOAJ
description Abstract Introduction Most of the studies on PKU have focused on the neurological development of patients. Studies regarding the physical development usually cover a short period of time, do not include dietary information, and results are contradictory. The aim of this study is to determine whether the patients with PKU have a normal growth, the incidence of obesity and the relationship of these parameters with diet and nutritional intake. Material and methods This is a retrospective, multicenter, multinational study including patients with PKU from 8 centers from different countries. Data of growth parameters and dietary regimes were collected from birth until the age of 18 years. Anthropometric tools of the WHO (Anthro version 3.2.2 and Anthro plus) were used to calculate z-score for weight-for-age, height-for-age and body mass index (BMI). Results Data from 182 patients with classical PKU were included. The median height z-scores for both male and female patients showed a normal growth pattern according to the WHO charts. Significant positive correlation  was observed between height z-score and the Phe (mg/day) and natural protein (g/day) intakes in all ages, especially in children younger than 11 years. The amount of Phe-free amino acid mixture did not affect the height, but lower intakes were negative correlated with the BMI. Also, we detected a positive correlation between the median Phe levels and BMI, meaning that the poorer metabolic control was correlated with higher BMI. Conclusions An objective of PKU is that patients have satisfactory final physical development; the height prognosis seems to be associated with Phe and natural protein intake and therefore should be optimized. It is important to collect longitudinal growth data throughout childhood and adolescence in PKU that considers any change in growth in relationship to dietary patterns.
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spelling doaj-art-c460ee2b6bb74f878d48a4c85e7da7942025-08-20T04:02:46ZengBMCOrphanet Journal of Rare Diseases1750-11722025-08-012011710.1186/s13023-025-03946-3Multicenter study on long-term growth in patients with phenylketonuriaS. Stanescu0A. Belanger-Quintana1J. C. Rocha2M. F. Almeida3K. Ahring4K. Dokoupil5A. M. Lammardo6E. van Dam7A. Muriel8A. MacDonald9on behalf of the ENEP groupU. Enf. Metabolicas, Paediatric Department, MetabERN, Hospital Universitario Ramón y CajalU. Enf. Metabolicas, Paediatric Department, MetabERN, Hospital Universitario Ramón y CajalNutrition & Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de LisboaCentro de Referência Para As Doenças Hereditárias Do Metabolismo, Unidade Local de Saúde de Santo AntónioCenter for PKU, Kennedy InstituteDp Metab Nutr, Dr Hauner Child HospDp Pediatric, San Paolo Hosp, Univ MilanS. Metab Dis, Univ Med Centre GroningenU. Bioestadística Clínica, Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y CajalDietetic Department, Birmingham Children’s HospitalAbstract Introduction Most of the studies on PKU have focused on the neurological development of patients. Studies regarding the physical development usually cover a short period of time, do not include dietary information, and results are contradictory. The aim of this study is to determine whether the patients with PKU have a normal growth, the incidence of obesity and the relationship of these parameters with diet and nutritional intake. Material and methods This is a retrospective, multicenter, multinational study including patients with PKU from 8 centers from different countries. Data of growth parameters and dietary regimes were collected from birth until the age of 18 years. Anthropometric tools of the WHO (Anthro version 3.2.2 and Anthro plus) were used to calculate z-score for weight-for-age, height-for-age and body mass index (BMI). Results Data from 182 patients with classical PKU were included. The median height z-scores for both male and female patients showed a normal growth pattern according to the WHO charts. Significant positive correlation  was observed between height z-score and the Phe (mg/day) and natural protein (g/day) intakes in all ages, especially in children younger than 11 years. The amount of Phe-free amino acid mixture did not affect the height, but lower intakes were negative correlated with the BMI. Also, we detected a positive correlation between the median Phe levels and BMI, meaning that the poorer metabolic control was correlated with higher BMI. Conclusions An objective of PKU is that patients have satisfactory final physical development; the height prognosis seems to be associated with Phe and natural protein intake and therefore should be optimized. It is important to collect longitudinal growth data throughout childhood and adolescence in PKU that considers any change in growth in relationship to dietary patterns.https://doi.org/10.1186/s13023-025-03946-3PhenylketonuriaGrowthDietNatural protein intake
spellingShingle S. Stanescu
A. Belanger-Quintana
J. C. Rocha
M. F. Almeida
K. Ahring
K. Dokoupil
A. M. Lammardo
E. van Dam
A. Muriel
A. MacDonald
on behalf of the ENEP group
Multicenter study on long-term growth in patients with phenylketonuria
Orphanet Journal of Rare Diseases
Phenylketonuria
Growth
Diet
Natural protein intake
title Multicenter study on long-term growth in patients with phenylketonuria
title_full Multicenter study on long-term growth in patients with phenylketonuria
title_fullStr Multicenter study on long-term growth in patients with phenylketonuria
title_full_unstemmed Multicenter study on long-term growth in patients with phenylketonuria
title_short Multicenter study on long-term growth in patients with phenylketonuria
title_sort multicenter study on long term growth in patients with phenylketonuria
topic Phenylketonuria
Growth
Diet
Natural protein intake
url https://doi.org/10.1186/s13023-025-03946-3
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