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Health-related quality of life and cognitive functioning in pediatric short stature: comparison of growth-hormone-naïve, growth-hormone-treated, and healthy samples

Abstract

The objective of this study was to evaluate the impact of short stature on generic health-related quality of life (HRQOL) and cognitive functioning in pediatric patients. Eighty-nine youth, 48 who were initially seen with short stature (SS group) and 41 with a history of short stature being treated with growth hormone (GHT group) and one of their legal guardians participated in the study. HRQOL and cognitive functioning were assessed using the PedsQL™ 4.0 Generic Core Scales and PedsQL™ Cognitive Functioning Scale. Comparisons were made between the study groups and with a previously obtained matched healthy sample. For the GHT group, height Z score was found to be a positive predictor of overall HRQOL while duration of GHT was found to be a predictor of physical functioning. For the SS group, the difference between midparental height Z score and height Z score was found to be a negative predictor of overall HRQOL and cognitive functioning. Comparison with the healthy sample demonstrated significant negative impact on HRQOL for child self-report and on HRQOL and cognitive functioning for parent proxy-report in both study groups. The GHT group had a significantly higher child self-reported Physical Functioning score than the SS group (effect size (ES) = 0.52, p < 0.05). In conclusion, the GHT group had slightly better HRQOL scores than the SS group, but the difference was not statistically significant. Both groups had significantly lower HRQOL and cognitive functioning scores than healthy sample. Predictors of HRQOL and cognitive functioning found in this study lend support to the use of the PedsQL™ 4.0 Generic Score Scales and PedsQL™ Cognitive Functioning Scale in routine assessment of children with short stature in order to identify children at increased risk for impaired HRQOL and cognitive functioning.

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Acknowledgments

Appreciation is expressed to our patients and their families who made this study possible, and to the various medical providers who allowed us to enroll their patients in this study. Special thanks to Kyrie Collins RN, Nunilo Rubio MD, Robyn Klenk RN, FNP-C, MSN and Parvin Yazdani MD who assisted with enrolling patients when the primary investigator was not available and William Risser MD, PhD for editorial contributions.

Competing Interest

Dr. Varni holds the copyright and the trademark for the PedsQL™ and receives financial compensation from the MAPI Research Trust, which is a nonprofit research institute that charges distribution fees to for-profit companies that use the Pediatric Quality of Life Inventory™.

Funding

Funding was provided through an intradepartmental grant from the University of Texas Health Science Center at Houston.

Author information

Correspondence to Matthew D. Stephen.

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Stephen, M.D., Varni, J.W., Limbers, C.A. et al. Health-related quality of life and cognitive functioning in pediatric short stature: comparison of growth-hormone-naïve, growth-hormone-treated, and healthy samples. Eur J Pediatr 170, 351–358 (2011). https://doi.org/10.1007/s00431-010-1299-z

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Keywords

  • Quality of life
  • Short stature
  • PedsQL
  • Cognitive functioning
  • Growth hormone
  • Patient-reported outcomes