Study finds twice as many boys than girls referred for growth hormone stimulation tests

Prior studies have indicated a gender bias for referral for short stature evaluation, with more boys being referred and diagnosed with growth hormone deficiency (GHD) than girls. A study presented at ENDO 2024 reiterated these findings, indicating that two-thirds of referrals for growth hormone stimulation tests were in boys.

Researchers retrospectively conducted a chart review of children <18 years who underwent growth hormone stimulation tests at their facility between 2017 and 2021, focusing on differences in gender and growth hormone secretion status.

Among 400 children included in the analysis, 266 (66.5%) were boys and 134 (33.5%) were girls. The mean patient age was 8.8 years, mean height z-score was –2.3, and mean mid-parental height (MPH) standard deviation score (SDS) was –0.6.

The mean difference between MPH-SDS and child height-z-score was 1.7. Mean age was younger in girls than boys: 7.3 versus 9.6 (P<0.001). Referrals for analysis peaked between age 3 to 4 years of age for both girls and boys; however, there was a second peak at age 13 to 14 years in boys only.

There was no significant difference between boys and girls in height z-score, difference from MPH SDS, or rates of GHD. Overall, 93 (23.3%) children were diagnosed with GHD: 32 girls (24%) and 61 boys (23%). Children with GHD were younger (7.8 vs 9.2 years; P=.003) and had higher body mass index SDS (BMI z-score, 0.17 vs –0.47; P<.001) compared with children who did not have GHD.

“This male-to-female ratio is similar to ratios reported in the literature regarding short stature referrals; however, in contrast to the literature, in our cohort it could not be explained by an anthropometric bias in referral criteria,” the authors concluded.

Reference

Dekel Y, Horowitz L, Gendelman R, Cohen M. Gender based differences in peripubertal growth patterns may offer insight into the twofold representation of boys compared to girls among children referred for growth hormone stimulation tests. Abstract MON-195. Presented at ENDO 2024, June 1-4, 2024, Boston, Massachusetts.