ESPE Abstracts

Background: Regional variations in height standard deviation scores (SDS) are documented in the literature due to a multitude of factors such as diverse ethnicities, social determinants, migration patterns, and lifestyle. Referrals to pediatric endocrine clinics for short stature are frequent, often guided by standardized criteria set for primary care or clinical indications from secondary care in the UK.

Objective: 1) To compare height standard deviation scores (SDS) for children with short stature in two neighboring cities (Leeds and Bradford), which cover a population of around 2 million people 2) To investigate similarities and differences in height at referral. Children were aged between 4-16 years and referred as a new patient from 2013 to 2023

Methodology: For each patient, decimal age height, weight, BMI SDS, and diagnosis were recorded at the time of initial diagnosis and the point of final review (or discharge)

Results: 780 consecutive referrals were reviewed (240 children in Bradford and 540 pediatric children to Leeds Teaching Hospitals). The mean age of referral was 8.5 years (±4.5 SDS) in Bradford and 8.3 years (±4.7 SDS) in Leeds. In Bradford, the male-to-female distribution was 142 (59%) and 98 (41%), while in Leeds, it was 279 (58%) and 261 (42%). In Bradford, the mean height SDS at the initial visit was -2.78 (±1.01SDS) and -2.45 (±1.3SDS) at the final review. In Leeds, the mean SDS for height at the initial visit was -2.3 (±1.1SDS), and -1.9 (±1.14 SDS) at the final review. The most common reason for referral for short stature in Bradford was familial short stature (33 cases, 12%), and growth hormone (GH) deficiency (20 cases, 8%). While in Leeds, about 36(7%) children have familial short stature, and GH deficiency in 37(8.2%) children Numbers with extreme height SDS (-4 SDS): in Bradford 24 children had a height of less than- 4 SDS (10%) and in Leeds 28 had a height of less than -4 SDS (5.2%) at referral.

Conclusion: There was no difference in the age at referral. Both centers had a greater number of referrals for boys. At the initial visit, children in Bradford had a lower height SDS and also a greater proportion of children with extremely short height SDS (>-4) than in Leeds. Bradford has a diverse and consanguineous population and greater social deprivation. A review is the underlying pattern of disease type is ongoing.