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Gender Bias in U.S. Pediatric Growth Hormone Treatment

Growth hormone (GH) treatment of idiopathic short stature (ISS), defined as height <−2.25 standard deviations (SD), is approved by U.S. FDA. This study determined the gender-specific prevalence of height <−2.25 SD in a pediatric primary care population, and compared it to demographics of U.S....

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Autores principales: Grimberg, Adda, Huerta-Saenz, Lina, Grundmeier, Robert, Ramos, Mark Jason, Pati, Susmita, Cucchiara, Andrew J., Stallings, Virginia A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650610/
https://www.ncbi.nlm.nih.gov/pubmed/26057697
http://dx.doi.org/10.1038/srep11099
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author Grimberg, Adda
Huerta-Saenz, Lina
Grundmeier, Robert
Ramos, Mark Jason
Pati, Susmita
Cucchiara, Andrew J.
Stallings, Virginia A.
author_facet Grimberg, Adda
Huerta-Saenz, Lina
Grundmeier, Robert
Ramos, Mark Jason
Pati, Susmita
Cucchiara, Andrew J.
Stallings, Virginia A.
author_sort Grimberg, Adda
collection PubMed
description Growth hormone (GH) treatment of idiopathic short stature (ISS), defined as height <−2.25 standard deviations (SD), is approved by U.S. FDA. This study determined the gender-specific prevalence of height <−2.25 SD in a pediatric primary care population, and compared it to demographics of U.S. pediatric GH recipients. Data were extracted from health records of all patients age 0.5–20 years with ≥ 1 recorded height measurement in 28 regional primary care practices and from the four U.S. GH registries. Height <−2.25 SD was modeled by multivariable logistic regression against gender and other characteristics. Of the 189,280 subjects, 2073 (1.1%) had height <−2.25 SD. No gender differences in prevalence of height <−2.25 SD or distribution of height Z-scores were found. In contrast, males comprised 74% of GH recipients for ISS and 66% for all indications. Short stature was associated (P < 0.0001) with history of prematurity, race/ethnicity, age and Medicaid insurance, and inversely related (P < 0.0001) with BMI Z-score. In conclusion, males outnumbered females almost 3:1 for ISS and 2:1 for all indications in U.S. pediatric GH registries despite no gender difference in height <−2.25 SD in a large primary care population. Treatment and/or referral bias was the likely cause of male predominance among GH recipients.
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spelling pubmed-46506102015-11-24 Gender Bias in U.S. Pediatric Growth Hormone Treatment Grimberg, Adda Huerta-Saenz, Lina Grundmeier, Robert Ramos, Mark Jason Pati, Susmita Cucchiara, Andrew J. Stallings, Virginia A. Sci Rep Article Growth hormone (GH) treatment of idiopathic short stature (ISS), defined as height <−2.25 standard deviations (SD), is approved by U.S. FDA. This study determined the gender-specific prevalence of height <−2.25 SD in a pediatric primary care population, and compared it to demographics of U.S. pediatric GH recipients. Data were extracted from health records of all patients age 0.5–20 years with ≥ 1 recorded height measurement in 28 regional primary care practices and from the four U.S. GH registries. Height <−2.25 SD was modeled by multivariable logistic regression against gender and other characteristics. Of the 189,280 subjects, 2073 (1.1%) had height <−2.25 SD. No gender differences in prevalence of height <−2.25 SD or distribution of height Z-scores were found. In contrast, males comprised 74% of GH recipients for ISS and 66% for all indications. Short stature was associated (P < 0.0001) with history of prematurity, race/ethnicity, age and Medicaid insurance, and inversely related (P < 0.0001) with BMI Z-score. In conclusion, males outnumbered females almost 3:1 for ISS and 2:1 for all indications in U.S. pediatric GH registries despite no gender difference in height <−2.25 SD in a large primary care population. Treatment and/or referral bias was the likely cause of male predominance among GH recipients. Nature Publishing Group 2015-06-09 /pmc/articles/PMC4650610/ /pubmed/26057697 http://dx.doi.org/10.1038/srep11099 Text en Copyright © 2015, Macmillan Publishers Limited http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Article
Grimberg, Adda
Huerta-Saenz, Lina
Grundmeier, Robert
Ramos, Mark Jason
Pati, Susmita
Cucchiara, Andrew J.
Stallings, Virginia A.
Gender Bias in U.S. Pediatric Growth Hormone Treatment
title Gender Bias in U.S. Pediatric Growth Hormone Treatment
title_full Gender Bias in U.S. Pediatric Growth Hormone Treatment
title_fullStr Gender Bias in U.S. Pediatric Growth Hormone Treatment
title_full_unstemmed Gender Bias in U.S. Pediatric Growth Hormone Treatment
title_short Gender Bias in U.S. Pediatric Growth Hormone Treatment
title_sort gender bias in u.s. pediatric growth hormone treatment
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650610/
https://www.ncbi.nlm.nih.gov/pubmed/26057697
http://dx.doi.org/10.1038/srep11099
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