Growth hormone treatment and the risk of adolescent scoliosis: A large matched cohort study

Tomer Ziv-Baran, Dalit Modan-Moses, Galia Zacay, Nissim Ackshota, Yael Levy-Shraga*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Aim: We aimed to evaluate the risk of developing adolescent scoliosis among recipients of recombinant human growth hormone (rhGH). Methods: This registry-based cohort study included 1314 individuals who initiated rhGH treatment since 2013, treated during 10–18 years of age for at least 6 months. This group was matched to a comparison group of 6570 individuals not treated with rhGH. Demographic and clinical information was extracted from the electronic database. The results are presented using hazard ratios (HR) and 95% confidence intervals (CI). Results: During a median follow-up of 4.2 years, 59 (4.5%) rhGH recipients and 141 individuals (2.1%) from the comparison group were diagnosed with adolescent scoliosis. The age at diagnosis did not differ between the groups (14.7 versus 14.3 years, p = 0.095). Patients treated with rhGH were more likely diagnosed with scoliosis (HR 2.12, 95% CI 1.55–2.88, p < 0.001). Among males, the risk was about three times greater in the treated versus the comparison group (HR 3.15, 95% CI 2.12–4.68, p < 0.001), while in females the risk was not increased (HR 1.12, 95% CI 0.72–2.04, p = 0.469). Conclusions: Recombinant human growth hormone treatment was associated with an increased risk to be diagnosed with adolescent scoliosis in males. Scoliosis development should be monitored appropriately in rhGH recipients.

Original languageEnglish
Pages (from-to)1240-1248
Number of pages9
JournalActa Paediatrica, International Journal of Paediatrics
Issue number6
StatePublished - Jun 2023


  • adolescents
  • recombinant human growth hormone
  • scoliosis
  • side effects


Dive into the research topics of 'Growth hormone treatment and the risk of adolescent scoliosis: A large matched cohort study'. Together they form a unique fingerprint.

Cite this