Short boys more likely to receive growth hormone treatment

Short boys in the US are three times more likely than short girls to receive human growth hormone treatment for idiopathic short stature (ISS), a condition that refers to children who are shorter than normal with no known cause, a research has found.

The US Food & Drug Administration defines ISS as height more than 2.25 standard deviations below mean for age and gender, without evidence of underlying disease.

The analysis involving records of over 283,000 US children and adolescents found a clear-cut and persistent gender bias in the provision of treatment.

"Growth is an important sign of child health, so growth failure merits equal consideration for both boys and girls," said study leader Adda Grimberg, pediatric endocrinologist at The Children's Hospital of Philadelphia (CHOP).

"Gender bias in treatment may have doubly undesirable effects -- short girls who have an underlying disease, while short healthy boys may receive overzealous, unnecessary treatment with an expensive drug that requires years of nightly injections and has potential side effects," Grimberg said.

The study published their study on June 9 in the journal Scientific Reports.

The study team drew on health records from 28 primary care practices in the CHOP pediatric network, comprising 189,280 patients, and compared them to 93,736 patients from the four US pediatric growth hormone registries. All the subjects were children and adolescents (up to age 20).

Among patients who received the hormone for all diagnoses, 66 percent were male.

At the time of initiating growth hormone for ISS, treated boys outnumbered girls for every year of age starting at age one, but the biggest differences occurred around puberty, the results showed.

The authors noted that both physicians and parents contribute to the gender-based treatment bias.