ESPE Abstracts

Introduction: Idiopathic short stature (ISS) is characterized by a reduced height (at least 2 standard deviation scores [SDS]) from expected norms based on age, sex, and population-specific height standards in the absence of growth hormone (GH) deficiency or other known etiologies. ISS is a registered indication for GH therapy in USA but not in Europe. The psychosocial burden of ISS remains underexplored, including its impact on quality of life. Using National Danish administrative registry data, we investigated the impact of ISS on primary school children’s well-being.

Methods and materials: In the National Children's Database, 1.4 million children had recordings of heights obtained by school health nurses or general practitioners. Children fulfilling the criteria for ISS were defined as the primary case population and were matched to at least one control in the period from 2012 to 2020. Children registered with an ICD-10 code referring to known causes of short stature (born small for gestational age, diagnosis of chronic disease, genetic or chromosomal aberrations, etc.) in the Danish National Patient Registry were excluded. Thus, the final cohort included 16,121 children with ISS. A secondary case population consisting of children with a height ≤-2.5 SDS was also assessed (n = 5,131). Children’s well-being was assessed by the yearly National Well-being Survey and responses were compared to a matched control group of 35,238 children with a normal height. The analysis was conducted separately for children in grade 0-3 (age 6-9), grade 4-6 (age 10-12), and grade 7-9 (age 13-15) due to differences in survey questionnaires.

Results: Across all grades, children with ISS reported lower social well-being compared to their matched controls. In grades 4-6, 4.7% of children with ISS experienced teasing or bullying compared to 3.4% of controls implying a 37% increase in the probability of having experienced teasing or bullying. Furthermore, children with ISS in grades 4-6 report greater loneliness with an estimated increased probability of 19% and 10% for girls and boys, respectively. The magnitude of the relative differences was amplified when comparing the responses of the children from the case population with height ≤-2.5 SDS to those of their matched controls.

Conclusion: ISS was associated with significantly lower self-reported well-being in primary school children. Well-being scores were especially affected within the domains of bullying and teasing. The effects of ISS on well-being were found to be even more pronounced for children with a height ≤-2.5 SDS.