Prevalence and demographic features of childhood growth hormone deficiency in Belgium during the period 1986-2001

Abstract

Objective: Since the availability of recombinant human growth hormone (rhGH) all children with growth hormone deficiency (GHD) living in Belgium are offered rhGH treatment after approval by a peer -review board. In this study, we evaluated the prevalence and demographic features of childhood GHD in Belgium during the period 1986 -2001 and we compared them with the data from other countries. Methods: Diagnostic, demographic and baseline auxological data of 714 children diagnosed as having GHD between 1986 and 2001 were retrieved from the database of the Belgian Study Group for Paediatric Endocrinology. Results: The prevalence of GHD in Belgium was estimated to be 1/5600. The origin of GHD was idiopathic (idGHD) in 41% of the patients, congenital (congGHD) in 20% and acquired (acqGHD) in 35%. During the first 4 years (1986 -1989) more patients were classified as idGHD; thereafter the distribution between the three aetiology groups did not change. In all groups, boys outnumbered girls but this preponderance was especially pronounced in congGHD patients (male:female ¼ 4:1) with a central malformation that associates an anterior pituitary hypoplasia, a missing, fine or normal pituitary stalk and an ectopic posterior pituitary. Thirteen percent of the patients with idGHD, 50% with congGHD and 52% with acqGHD had multiple pituitary deficiencies. Patients with congGHD were the youngest (mean^S.D. age: 6.5^4.7 years) and were the shortest (2 3.0^1.3 standard deviation score (SDS)) at the start of rhGH treatment. There was no time trend over the studied period for age and height at onset of GH therapy. Conclusion: In Belgium, the prevalence of childhood GHD can be estimated as 1/5600 which is comparable to other recent surveys. The yearly number of new patients for the different aetiologies and the auxological parameters have remained relatively constant over the last 16 years.

Recombinant human growth hormone for the treatment of growth disorders in children: a systematic review and economic evaluation

“…The origin of GHD was stated to be unknown in 41% of the patients in this Belgian study, congenital in 20% and acquired in 35%. 8 While the authors of this study state that these yearly numbers have remained similar across the 16 years of the study, these were not collected as part of a formal screening study, and, as a result, the study authors believe that this figure is an underestimation. 8 A Danish study calculated incidence rates of childhood-onset growth hormone deficiency (CO-GHD), based on 1823 patients incident during 1980-99.…”

“…8 While the authors of this study state that these yearly numbers have remained similar across the 16 years of the study, these were not collected as part of a formal screening study, and, as a result, the study authors believe that this figure is an underestimation. 8 A Danish study calculated incidence rates of childhood-onset growth hormone deficiency (CO-GHD), based on 1823 patients incident during 1980-99. The average incidences per 100,000 population were calculated to be 2.58 [95% confidence interval (CI) 2.3 to 2.88] for males, and 1.70 (95% CI 1.48 to 196) for females.…”

“…Figures from a study in Belgium 8 indicate an overall prevalence of GHD of 1 in 5600. The origin of GHD was stated to be unknown in 41% of the patients in this Belgian study, congenital in 20% and acquired in 35%.…”

Prenatal MR Imaging of the Normal Pituitary Stalk

“…CH is rare; its prevalence is estimated to be approximately between 1/5000 and 1/30,000 children, according to different studies. 5,6 However, CH may result in severe and unpredictable neonatal hypoglycemic encephalopathy. 7,8 The early detection of pituitary gland dysfunction (in particular of growth hormone deficiency) might help in planning for advance hormone replacement therapy.…”

Growth monitoring for short stature: update of a systematic review and economic model

“…Estimates of prevalence range from 1 in 3500 to 1 in 7000. 4 Early diagnosis is beneficial to maximise final height; if left untreated, GHD results in a reduced adult height, an average of 4.7 standard deviations (SDs) below the mean. 5 With treatment, final height can be within 1 SD of the norm.…”