BSPED2024 Poster Presentations Pituitary and Growth (8 abstracts)
Clinical assessment for and response to growth hormone in a tertiary paediatric endocrine service: social and gender factors
Lily Jones 1 , Vasiliki Alexopoulou 2 , Urmi Das 2 , Poonam Dharmaraj 2 , Mohammed Didi 2 , Peter Laing 2 , Renuka Ramakrishnan 2 , Senthil Senniappan 2 , Zoe Yung 2 & Joanne Blair 2,3
1School of Medicine, University of Liverpool, Liverpool, United Kingdom; 2Department of Endocrinology, Alder Hey Children’s Hospital NHS Trust, Liverpool, United Kingdom; 3NIHR Alder Hey Clinical Research Facility, Liverpool, United Kingdom
Introduction: Delayed detection of short stature can lead to missed opportunities to optimise adult height and failure to diagnose important underlying pathologies. We speculated that children from more deprived communities may be less likely to be diagnosed with growth hormone (GH) deficiency, and that growth outcomes may be poorer in children treated with GH from deprived communities, in light of outcome data from other chronic childhood conditions. We compared the demographics of patients receiving GH for isolated GHD (IGHD) and small-for-gestational-age (SGA) without catch-up growth with the background population and described demographic factors affecting outcomes after one year of treatment.
Methods: Retrospective cohort study of children treated for ≥1 year. Exclusion criteria: (1) additional diagnoses associated with short stature; (2) could not be measured accurately; (3) medications that may affect growth. Routine clinical data were collected for 86 IGHD patients and 46 SGA patients.
Results: Data are reported for 81 IGHD and 42 SGA patients. Both cohorts showed a male predominance: 76.5% (n = 62) in IGHD and 76.2%(n = 32) in SGA. Most patients were White British (IGHD: 90.1%, SGA: 87.2%), consistent with the background population (89.4%). The median Index-of-Multiple-Deprivation (IMD) decile was 5.0 (IQR 7.0) for IGDH and 2.0 (IQR 6.0) for SGA (Table 1). Factors that may represent differences in accessibility to GH treatment (average age reviewed, height and BMI SDS prior to GH, age commencing GH) did not differ between boys and girls, or by IMD. A significant positive correlation existed between IMD decile and height SDS gain after one year in the SGA cohort (Spearman’s rho 0.442, P = 0.003), but not in the IGHD cohort.
| Decile | 2019 Census, % | IGHD, %(n = 81) | SGA, %(n = 42) |
| 1-to-3 | 43.4 | 45.7(37) | 52.4(22) |
| 4-to-7 | 29.6 | 19.8(16) | 26.2(11) |
| 8-to-10 | 27.0 | 34.5(28) | 21.4(9) |
Conclusion: Girls are likely under-referred, investigated and treated for short stature. Once diagnosed, treatment outcomes for GH are similar to boys. In this small cohort, there was no evidence of bias in favour of diagnosis of IGHD or treatment of SGA by IMD; however, deprivation is associated with poorer outcomes in SGA patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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