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Growth Hormone Deficiency

Link found between short stature, growth hormone therapy, and scoliosis

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Individuals with short stature, particularly those undergoing recombinant human growth hormone (rhGH) therapy, face an increased risk of developing scoliosis, according to a study, which highlights the importance of closely monitoring spinal health in patients with partial growth hormone deficiency (GHD), GHD, or idiopathic short stature (ISS).

The study included 3896 patients with short stature (encompassing partial GHD, GHD, and ISS), along with an age- and sex-matched control group. Whole-spine radiographs from both the patient and control groups were analyzed. A cohort study was conducted involving 2605 subjects who underwent radiography multiple times to assess scoliosis development, progression, and the necessity for bracing or surgery.

In comparison to the control group, individuals with short stature demonstrated a higher prevalence of scoliosis (partial GHD: 34.47%, GHD: 31.85%, ISS: 32.94% vs Control: 8.83%,  P < 0.001), as well as an elevated risk of scoliosis development (HR=1.964 in partial GHD, P < 0.001; HR=1.881 in GHD, P = 0.001; HR=1.706 in ISS, P = 0.001). However, no notable disparities were observed in terms of progression, need for bracing, or surgery across the 3 types of short stature. Notably, rhGH therapy amplified the risk of scoliosis development in each short stature subgroup (HR=2.673 in partial GHD, P <0.001; HR=1.924 in GHD, P = 0.049; HR=1.564 in ISS, P = 0.004). Furthermore, vitamin D supplementation demonstrated a protective effect against scoliosis development (HR=0.456 in partial GHD, P =0.003; HR=0.42 in GHD, P = 0.013; HR=0.838 in ISS, P = 0.257).

Reference
Hong H, Hu J, Xu H, et al. Beyond growth hormone: association of short stature types and growth hormone with scoliosis. Spine (Phila Pa 1976). 2023;doi: 10.1097/BRS.0000000000004853. Epub ahead of print. PMID: 37871182.

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