Association between Idiopathic Scoliosis and GH Treatment in Children of Short Stature

Abstract

Objective: Idiopathic scoliosis is the most common form of scoliosis in children and adolescents, and the risk of its development and progression has been shown to be linked to growth spurts. Treatment with recombinant human growth hormone (rhGH) in children with short stature may cause the development and progression of scoliosis. Aim of the Study: The aim of this study was to investigate the relationship between idiopathic scoliosis and rhGH treatment in short stature children. Methods: we collected 80 medical records of patients with short stature diagnosed with growth hormone deficiency (GHD) and small for gestational age (SGA) without catch-up by the age of 4 years, between May 2014 and December 2021. Scoliosis was defined as a Cobb angle greater than 10° assessed using a spine X-ray. Clinical data and biochemical results were compared before and 12 months after rhGH treatment. Results: we observed a significant increase in height and insulin-like growth factor 1 (Igf1) (P < 0.001) with rhGH treatment. However, there were no significant differences in mean Cobb angle (6.2 ± 3.4° versus 6.3 ± 3.5, P = 0.95) before and after one year of rhGH treatment. Conclusion: Although rhGH treatment in children with short stature increases height and growth velocity, our results demonstrated that rhGH is not associated with the development or progression of idiopathic scoliosis.

Keywords: growth hormone; idiopathic scoliosis; growth hormone deficiency; short stature; small for gestational age (SGA).