English
conference proceeding
Wit,J.M., Van-Balen, H., Theunissen,
N.C.M., Bolt, I., & (2001) Growth Hormone (GH)treatment and changes
in Quality of life. Pediatric Research, 49 (6, supplement: Paediatric
Endocrinology Montreal, June 2001).
Abstract
The use of GH in non-GH-Deficient short
children has been initiated and defended on the assumption that short
stature leads to some form of suffering, which can be aleviated by growth
promoting treatment and for which no other effective therapy is available.
The evidence for these assumptions will be reviewed, particularly in children
with idiopathic short stature. The question whether short stature leads
to suffering can also be formulated by the question whether it is a relevant
risk factor in the context of other risk and protective factors associated
with the biological makeup of the child and its immediate environment
and social, economic and cultural context. There is a great diversity
of study results in terms of social competence, social functioning, behavior
(externalizing and internalizing problems), body image, self image, cognitive
functioning and school competence. Studies in young adults with a history
of short stature in childhood have shown few effects on quality of life.
In general, the impact of short stature appears modest, but may depend
on the presence or absence of other risk and protective factors (sex,
age, intelligence, parental attitudes, being teased, socia-economic status,
prevailing cultural opinions, etc). The diversity of results appears related
to methodological factors (generic versus instruments) and to the choice
of study populations. Similar considerations apply to the studies on the
effect of GH on psychosocial parameters: in controlled studies generally
no major changes have been observed in school competence, behavior, self
image, body image, personality characteristics and cognitive functioning.
The same applies to follow-up studies in young adulthood. The consequences
of these findings for the approach to GH treatment in non-GHD short children,
either with disorders with a well-established etiology (such as turner
syndrome and renal failure) or with less well defined disorders (ISS,
intrauterine growth retardation) will be discussed.
Keywords
health related quality of life; health
status; treatment, idiopathic short stature; growth hormone treatment, development
