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Introduction <p>Recombinant human growth hormone (rhGH) treatment for idiopathic short stature (ISS) in China faces challenges including delayed initiation, poor persistence, limited adoption of advanced therapies, and conservative dosing. This study characterized real-world temporal and geographical patterns of rhGH therapy and identified associated socioeconomic factors.</p> Methods <p>Data from two nationwide registries comprising 24,384 children with ISS initiating rhGH were analyzed. Predictors of treatment effectiveness were identified via linear regression. Provincial variations and temporal trends were assessed via descriptive analysis and seasonal-trend decomposition. Spearman correlation was used to examine associations between treatment patterns and socioeconomic indicators.</p> Results <p>The median rhGH initiation age was 8.45&#xa0;years. Most patients (81.3%) initiated short-acting GH (SAGH; median dose 0.15&#xa0;IU/kg/day), while 18.7% initiated long-acting GH (LAGH; median dose 0.20&#xa0;mg/kg/week). Younger age and treatment duration ≥ 9&#xa0;months predicted superior 1-year height standard deviation score gain (<i>P</i> &lt; 0.001). Temporally, LAGH adoption and standard-dose regimens showed significant longitudinal increases (<i>P</i> &lt; 0.05). Geographically, substantial variation existed in median initiation age (7.11–9.70&#xa0;years), LAGH adoption rates (11.8–31.1%), and duration of therapy (DOT; 10.3–28.1&#xa0;months). Higher per capita gross regional product correlated with younger initiation (<i>ρ</i> = − 0.530), higher LAGH adoption (<i>ρ</i> = 0.371), and longer DOT (<i>ρ</i> = 0.552). Conversely, higher rural population ratios correlated with delayed initiation, lower LAGH adoption, and shorter DOT (all <i>P</i> &lt; 0.05).</p> Conclusion <p>Geographic heterogeneity in rhGH therapy is observed and correlates with regional socioeconomic profiles. To enhance therapeutic outcomes and support the balanced development of pediatric endocrine care, adaptive clinical management considering regional socioeconomic contexts is recommended.</p>

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Association Between Socioeconomic Indicators and Growth Hormone Treatment Patterns for Idiopathic Short Stature in China: A Large-Scale Real-World Study

  • 期刊论文

  • 发表日期：

    2026年4月30日

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  • Chunxiu Gong,
  • Xiaoping Luo,
  • Ruimin Chen,
  • Shengquan Cheng,
  • Xinran Cheng,
  • Hongwei Du,
  • Wei Gu,
  • Ke Huang,
  • Xiaoyan Huang,
  • Guimei Li,
  • Ping Li,
  • Tang Li,
  • Li Liang,
  • Deyun Liu,
  • Shu Liu,
  • Yu Liu,
  • Zhe Su,
  • Yan Sun,
  • Chunlin Wang,
  • Naijun Wan,
  • Haiying Wu,
  • Su Wu,
  • Wei Wu,
  • Yu Yang,
  • Hui Yao,
  • Xiaoyong Yuan,
  • Rongxiu Zheng,
  • Min Zhu

摘要

Introduction

Recombinant human growth hormone (rhGH) treatment for idiopathic short stature (ISS) in China faces challenges including delayed initiation, poor persistence, limited adoption of advanced therapies, and conservative dosing. This study characterized real-world temporal and geographical patterns of rhGH therapy and identified associated socioeconomic factors.

Methods

Data from two nationwide registries comprising 24,384 children with ISS initiating rhGH were analyzed. Predictors of treatment effectiveness were identified via linear regression. Provincial variations and temporal trends were assessed via descriptive analysis and seasonal-trend decomposition. Spearman correlation was used to examine associations between treatment patterns and socioeconomic indicators.

Results

The median rhGH initiation age was 8.45 years. Most patients (81.3%) initiated short-acting GH (SAGH; median dose 0.15 IU/kg/day), while 18.7% initiated long-acting GH (LAGH; median dose 0.20 mg/kg/week). Younger age and treatment duration ≥ 9 months predicted superior 1-year height standard deviation score gain (P < 0.001). Temporally, LAGH adoption and standard-dose regimens showed significant longitudinal increases (P < 0.05). Geographically, substantial variation existed in median initiation age (7.11–9.70 years), LAGH adoption rates (11.8–31.1%), and duration of therapy (DOT; 10.3–28.1 months). Higher per capita gross regional product correlated with younger initiation (ρ = − 0.530), higher LAGH adoption (ρ = 0.371), and longer DOT (ρ = 0.552). Conversely, higher rural population ratios correlated with delayed initiation, lower LAGH adoption, and shorter DOT (all P < 0.05).

Conclusion

Geographic heterogeneity in rhGH therapy is observed and correlates with regional socioeconomic profiles. To enhance therapeutic outcomes and support the balanced development of pediatric endocrine care, adaptive clinical management considering regional socioeconomic contexts is recommended.