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Risk factors for scoliosis progression in children with idiopathic short stature on growth hormone therapy
Xinkai Zhang1, Haiping Ouyang1, Xueben Han1
1Department of Orthopedics, Key Laboratory of Child Development and Disorders (Ministry of Education), National Clinical Research Center for Child Health and Disorders, Children's Hospital Affliated to Chongqing Medical University, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.
Insights
Growth hormone (GH) therapy for idiopathic short stature (ISS) in children may increase scoliosis progression risk, especially with smaller initial curves. Continued GH treatment is a significant risk factor for worsening scoliosis.
Area of Science:
- Pediatric Endocrinology
- Orthopedics
- Growth Disorders
Background:
- Idiopathic short stature (ISS) is a common condition in children.
- Growth hormone (GH) therapy is a standard treatment for ISS.
- Scoliosis is a potential complication that requires monitoring during GH therapy.
Purpose of the Study:
- To analyze clinical characteristics of scoliosis in children with ISS undergoing GH treatment.
- To evaluate the influence of GH therapy on scoliosis progression.
- To identify risk factors for scoliosis progression in this cohort.
Main Methods:
- Retrospective study of children with scoliosis treated with GH (January 2021 - June 2024).
- Analysis of clinical scoliosis characteristics and comparison of progression rates between exposed and control groups.
- Logistic regression analysis to determine independent risk factors for scoliosis exacerbation.
Main Results:
- Scoliosis in this cohort presented as mild curvature (average Cobb angle 11.86°).
- The progression rate of scoliosis was significantly higher in the GH-treated group (risk ratio 4.26).
- Continued GH treatment and smaller initial Cobb angles were identified as independent risk factors for progression.
Conclusions:
- Scoliosis associated with GH therapy for ISS is typically mild initially.
- Continued GH treatment poses an increased risk of scoliosis progression.
- Children with smaller initial Cobb angles require closer monitoring due to higher progression risk.
Objective:
To analyze the clinical characteristics of scoliosis in children with idiopathic short stature after growth hormone treatment, and to explore the influence of growth hormone treatment on the progression of scoliosis and the risk factors for the progression of scoliosis.
Methods:
A retrospective study of children with scoliosis treated with growth hormone between January 2021 and June 2024 was conducted, analyzing the clinical characteristics of scoliosis and comparing the progression rate of scoliosis between the exposure group and the control group. Independent risk factors for exacerbation of scoliosis were determined by univariate and multifactorial logistic regression analysis.
Results:
In this study, the average Cobb angle at initial diagnosis of scoliosis during recombinant human growth hormone (rhGH) therapy was 11.86° across all children, with a maximum value not exceeding 20°, consistent with mild scoliosis. Comparative analysis revealed significantly greater Cobb angles in females versus males at both initial angle (11.40 ± 1.72° vs. 12.25 ± 2.64 °, p<0.01) and outcome angle (10.83 ± 1.85° vs. 11.77 ± 2.60°, p < 0.01) And apical vertebrae were distributed in thoracic 10- lumbar 1 (64.17%). The progression rate of scoliosis in the exposure group was significantly higher than that in the control group, and the risk ratio was 4.26. In the exposed group, the scoliosis progression rate was 17.02% (8/39) in males versus 20.00% (13/52) in females (p = 0.69). Within controls, progression rates were 4.35% (2/44) in males and 4.44% (2/43) in females (p = 1.00). Univariate and multivariate logistic regression analyses showed that continued growth hormone treatment and the initial Cobb Angle were independent risk factors for scoliosis progression.
Conclusion:
(1) Scoliosis developing in children with idiopathic short stature (ISS) receiving growth hormone (GH) therapy predominantly manifests as mild curvature. (2) If scoliosis develops during GH therapy, continued treatment may increase the risk of scoliosis progression. (3) Patients with smaller initial Cobb Angles are at higher risk of progression, necessitating closer clinical monitoring for this subgroup.
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