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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

tatistic: that 41 percent of the girls were found to have an underlying disease that made them short, compared to 15 percent of the boys. Conversely, 38 percent of the boys were within normal height ranges, compared to 20 percent of the girls, and boys were referred for evaluation about twice as often as girls.

A variety of diseases may cause growth failure - among them, hormone deficiencies, Turner syndrome (a chromosome abnormality found only in females) and gastrointestinal conditions such as celiac disease or inflammatory bowel disease. For some, growth failure is the only symptom. "Gender differences in the use of rhGH may be indicative of more general gender differences in the diagnostic rates of diseases that present solely with growth failure," cautioned Dr. Grimberg. Not all of these diseases are treated by rhGH. For example, celiac disease is treated with a gluten-free diet. If a short girl is less likely to be perceived as needing rhGH treatment, she may also be less likely to undergo the diagnostic evaluation that reveals her underlying celiac disease.

The manufacture of rhGH in 1985 changed the treatment of pediatric growth failure. Prior to 1985, only children with the most severe growth hormone deficiency were treated because of the very limited supply of human pituitary GH. In 2003, the U.S. Food & Drug Administration (FDA) approved the use of rhGH for the treatment of idiopathic short stature, for children who are significantly shorter than their peers yet do not have an identifiable underlying disease.

The Pfizer International Growth Study (KIGS) was created in 1987, and the U.S. joined the database in 1996. It is the world's largest post-marketing surveillance database of rhGH use.

Dr. Grimberg is funded by an NIH grant from the National Institute of Diabetes, Digestive and Kidney Disease and an award from Children's Hospital. Dr. Grimberg's coauthors were Elizabeth Stewart and Michael P. Wajnrajch, M.D., both f
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SOURCE The Children's Hospital of Philadelphia
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