Growth hormone deficiency epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Epidemiology and Demographics

Incidence

• Sex
• The sex distribution of patients with idiopathic growth hormone deficiency is 73% male and 27% female. ^{[[null 4], [null 5], [null 6]]} Cuttler et al published results of a survey of pediatric endocrinologists that growth hormone treatment was 1.3 times more common in boys than in girls. ^{null 10}
• Age
• Diagnosis of growth hormone deficiency is made during 2 broad age peaks. The first age peak occurs at 5 years, a time when children begin school The second age peak occurs in girls aged 10-13 years and boys aged 12-16 years. While congenital GHD and most cases of idiopathic GHD are thought to be present from birth, diagnosis is often delayed until the patient’s short stature is noticed in relation to their peers. Race
• There is no apparent racial difference in the incidence of GHD the National Cooperative Growth Study (NCGS) Genentech’s now closed large North American database, revealed that 85% of patients receiving GH treatment for idiopathic GHD were white, 6% were black, and 2% were Asian. Gender
• Growth hormone deficiency affects males and females equally However, given the greater concern for boys with short stature in most societies, diagnosis tends to favor males over females. 73% of patients with idiopathic GHD in the NCGS were male. patients with GHD from organic causes such as tumors and radiation, in which no gender bias should be present, were still 62% male.
• In the United States commencing in the mid-1960s through April of 1985, natural human growth hormone (nGH) was used to treat child-onset GHD. In 1985, the FDA approved the use of Protropin brand of recombinant human (biosynthetic) growth hormone (rhGH) (somatropin [rDNA origin], manufacturered by Genentech, to treat child-onset GHD. Since then, similar, but not identical brands, of rhGH have come to the marketplace. In 1996, rhGH was approved or use in GHD adults. In the last 15 years, it has been recognized that growth hormone deficiency (GHD) in the adult leads to increased morbidity (metabolic syndrome, osteoporosis, muscle wasting, impaired quality of life) and increased incidence of cardiovascular events, a main cause of the increased mortality observed in this population. Pituitary adenomas and their treatment (surgery, radiation) are the most common cause of GHD in adults. In the United States, it is estimated that the incidence of growth hormone deficiency in children is between 1 in 4,000 and 1 in 10,000. More than 50,000 adults in the United States are growth hormone deficient, and 6,000 new cases are reported each year, including GHD children who transition to GHD as an adult.