The changes in health-related quality of life and psychological outcomes in Chinese children with short stature after growth hormone therapy.

Abstract

Objectives To evaluate longitudinal changes in mental health and health-related quality of life (HRQoL) among prepubertal Chinese children with short stature whose guardians selected recombinant human growth hormone (rhGH) therapy or observation, using both child self-reports and parent proxy-reports. Methods Retrospective, non-randomized study of 162 prepubertal Chinese children (ages 4-12 years) with short stature at a pediatric department in Xiaoshan District. Participants were grouped according to guardian treatment decisions: rhGH group (n = 45, treated for 12 months) and control group (n = 117, standard care only). Baseline anthropometric characteristics and Chinese PedsQL 4.0 scores at baseline and 1 year were analyzed. Group comparisons and within-group longitudinal changes were evaluated using appropriate statistical tests. Results At baseline, the groups were comparable in available demographic, anthropometric, and HRQoL variables (P > 0.05). After 1 year, the control group showed no statistically significant HRQoL changes (P > 0.05), whereas children whose guardians selected rhGH therapy showed increased HRQoL scores across physical, emotional, social, and school domains in both child and parent reports (P < 0.05). At 1 year, the rhGH group had higher overall and domain-specific HRQoL scores than controls (all P < 0.05). These findings should be interpreted as associations because treatment allocation was non-randomized and follow-up growth outcomes were not available in the analyzed dataset. Conclusion In this retrospective non-randomized cohort, rhGH therapy selected by guardians was associated with greater increases in child- and parent-reported HRQoL scores over 1 year compared with observation. Causal effects and growth-mediated psychosocial mechanisms cannot be inferred without adjustment for unmeasured confounders and follow-up growth outcomes.