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Growth Hormone is Used to Treat Twice as Many Short Boys Than Girls in the U.S. and Asia; Gender Difference is Smaller in the Rest of the World
Date:4/17/2008

aled a consistent overall male predominance among U.S. pediatric rhGH recipients at a nearly two-to-one ratio. The gender ratio did not change significantly across the more than 20 years of rhGH use. Males outnumbered females at all ages, especially during the second decade of life. Because boys typically start puberty later than girls and hit their growth spurt at a later stage of puberty, boys who lag behind their peers are more likely to be perceived as having a growth problem.

The factor that most consistently affected the gender distribution was the diagnostic indication for rhGH therapy. The greatest gender disparities occurred for diagnoses without an identifiable cause, such as idiopathic short stature and idiopathic GH deficiency because of the complexity of the diagnostic tests. Prader-Willi syndrome, a genetic disease with multiple benefits from rhGH therapy besides height, was the only indication with gender equality in the U.S. Dr. Grimberg hypothesized, "when the decision to treat involves an indication that relies more heavily on clinical judgment, treatment patterns are more likely to highlight underlying differences in social pressures for tallness."

Comparing the U.S. experience with global patterns revealed that Asia (mostly Japan) had the greatest male predominance at 65 percent, followed closely by the U.S. at 64 percent. Europe/Australia/New Zealand came third at 55 percent. All three world regions exceeded 50 percent males, while the rhGH recipients in the rest of the world regions, where rhGH is used far less frequently, were 47 percent male. Similar to the U.S. data, global gender distributions of rhGH depended on the specific reason the therapy was initiated. The United Kingdom had the lowest male percentage of the top 10 country-based children prescribed Genotropin(R).

Dr. Grimberg's earlier research in referral patterns for growth failure evaluations at a U.S. pediatric endocrinology clinic showed a disturbing s
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SOURCE The Children's Hospital of Philadelphia
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