ESPE Abstracts

Background: Short stature has been associated with a reduction in health-related quality of life (HRQoL) and more problem behavior in children and adults. In adolescents who were treated with growth hormone (GH) because of persistent short stature after being born SGA, an increase in HRQoL and decrease in behavioral problems was seen during or right after cessation of GH-treatment. However, long-term data, to analyze if these positive effects remain many years after GH-cessation, are lacking.

Objective: To longitudinally assess HRQoL and behavioral aspects in 30-year old adults born SGA who were treated with GH during childhood (SGA-GH).

Methods: HRQoL was assessed at 6 months, 2 years, 5 years and 12 years after GH cessation using the TNO-AZL Adults Quality of Life questionnaire (TAAQOL), which consists of 45 items and contains 12 scales; scales were scored from 0-100, 100 indicating the highest HRQoL. At similar time points, behavioural aspects were assessed using the Adolescent Behavior Check List (ABCL), which consists of 113 questions divided in 8 subscales and 3 main scales; total problem, externalizing (‘’conflicts with other people and with social mores”) and internalizing (“conflicts within the self”) problem behavior. Scales were transformed into standardized T-scores with a mean of 50 and standard deviation of 10, higher scores indicating more problem behavior. Different models for repeated measurement analysis were used, namely linear mixed model (LMM), Poisson LMM and Hurdle-Poisson model.

Results: We included 176 SGA-GH adults in the longitudinal assessment; 145 completed the TAAQoL questionnaire (56 at 6 months, 32 at 2 years, 79 at 5 years and 69 at 12 years after GH-cessation) and 107 completed the ABCL questionnaire (26 at 2 years, 53 at 5 years and 58 at 12 years after GH-cessation) at least at one of the follow-up visits. Mean birth length SDS was -3.4, mean adults height SDS was -1.7. HRQoL did not change over time in 8 subscales, in 3 subscales (gross motor functioning, pain and sleep) a decrease in HRQoL was found. No changes in behavioral aspects were found over time in the internalizing and total score, and a decrease in problem behavior was found in the externalizing score.

Conclusion: During 12 years after GH cessation, HRQoL remained similar in 9 of the 12 subscales and declined in 3 subscales, while problem behavior remained similar or decreased over time.