The changes in health-related quality of life and psychological outcomes in Chinese children with short stature after growth hormone therapy.
RhGH therapy may be associated with improved health-related quality of life in children with short stature compared to standard care, but causation cannot be established from this study.
Where it sits
this study against the rest of the hgh (somatropin) corpusSummary and findings
This study evaluated changes in health-related quality of life (HRQoL) and psychological outcomes in 162 prepubertal Chinese children with short stature after 12 months of recombinant human growth hormone (rhGH) therapy compared to standard care. The rhGH group (n=45) showed increased HRQoL scores across various domains, while the control group (n=117) showed no significant changes. The findings suggest an association rather than causation due to the non-randomized nature of the study.
Abstract
Objectives To evaluate longitudinal changes in mental health and health-related quality of life (HRQoL) among prepubertal Chinese children with short stature whose guardians selected recombinant human growth hormone (rhGH) therapy or observation, using both child self-reports and parent proxy-reports. Methods Retrospective, non-randomized study of 162 prepubertal Chinese children (ages 4-12 years) with short stature at a pediatric department in Xiaoshan District. Participants were grouped according to guardian treatment decisions: rhGH group (n = 45, treated for 12 months) and control group (n = 117, standard care only). Baseline anthropometric characteristics and Chinese PedsQL 4.0 scores at baseline and 1 year were analyzed. Group comparisons and within-group longitudinal changes were evaluated using appropriate statistical tests. Results At baseline, the groups were comparable in available demographic, anthropometric, and HRQoL variables (P > 0.05). After 1 year, the control group showed no statistically significant HRQoL changes (P > 0.05), whereas children whose guardians selected rhGH therapy showed increased HRQoL scores across physical, emotional, social, and school domains in both child and parent reports (P < 0.05). At 1 year, the rhGH group had higher overall and domain-specific HRQoL scores than controls (all P < 0.05). These findings should be interpreted as associations because treatment allocation was non-randomized and follow-up growth outcomes were not available in the analyzed dataset. Conclusion In this retrospective non-randomized cohort, rhGH therapy selected by guardians was associated with greater increases in child- and parent-reported HRQoL scores over 1 year compared with observation. Causal effects and growth-mediated psychosocial mechanisms cannot be inferred without adjustment for unmeasured confounders and follow-up growth outcomes.
Background
This study addresses the impact of growth hormone therapy on mental health and HRQoL in children with short stature, a topic of interest given the psychological implications of growth disorders. Prior research has suggested that growth hormone therapy may improve various health outcomes, but evidence specific to HRQoL and psychological outcomes in children remains limited. Understanding these effects is crucial for guiding treatment decisions in pediatric care.
Methods
This was a retrospective, non-randomized study involving 162 prepubertal Chinese children aged 4-12 years with short stature. Participants were divided into two groups based on guardian treatment decisions: a rhGH group (n = 45) treated for 12 months and a control group (n = 117) receiving standard care. The study analyzed baseline anthropometric characteristics and HRQoL scores using the Chinese PedsQL 4.0 at baseline and after 1 year.
Results
At baseline, no significant differences were found between the groups (P > 0.05). After 1 year, the control group did not show significant HRQoL changes (P > 0.05), while the rhGH group exhibited increased HRQoL scores across all measured domains (P < 0.05). The rhGH group had higher overall and domain-specific HRQoL scores compared to controls at 1 year (all P < 0.05).
Interpretation
The findings indicate that rhGH therapy may be associated with improved HRQoL in children with short stature, aligning with some previous studies that suggest potential benefits of growth hormone treatment. However, the effect sizes and clinical significance of these improvements are not specified, and the non-randomized nature of the study introduces confounding variables that limit the ability to draw definitive conclusions. The lack of follow-up growth outcomes further complicates the interpretation of these results.
Key findings
- At baseline, groups were comparable in demographic, anthropometric, and HRQoL variables (P > 0.05).
- After 1 year, the control group showed no statistically significant HRQoL changes (P > 0.05).
- Children whose guardians selected rhGH therapy showed increased HRQoL scores across physical, emotional, social, and school domains (P < 0.05).
- At 1 year, the rhGH group had higher overall and domain-specific HRQoL scores than controls (all P < 0.05).
Limitations
- non-randomized design limits causal inferences
- follow-up growth outcomes not available
- small sample size in rhGH group (n=45)
- reliance on parent proxy-reports may introduce bias