Adult Growth Hormone Deficiency, Replacement Therapy, and Outcomes in Long-Term Childhood Cancer Survivors
Bibliographic record
Abstract
CONTEXT: The consequences of untreated adult growth hormone deficiency (aGHD) among childhood cancer survivors are not well defined. The lack of evidence and socioeconomic factors may contribute to underutilization of growth hormone therapy (GHT) among survivors with aGHD. OBJECTIVES: This work aimed to examine the association of GHT use with socioeconomic factors and to assess the effect of untreated aGHD in survivors using insulin-like growth factor-1 (IGF1) as a marker of GH action. METHODS: A total of 3902 five-year survivors of childhood cancer aged 18 years and older were included. The associations between GHT use and socioeconomic factors (health insurance coverage, income, area deprivation index), and associations between IGF1 levels and prevalences of adverse physical, neurocognitive, and psychosocial outcomes were assessed cross-sectionally by multivariable logistic regression adjusting for potential confounders. RESULTS: Among 354 survivors with severe aGHD, 9.0% were on GHT. Socioeconomic disadvantages were independently associated with less use of GHT (eg, odds ratio [OR] of GHT use 0.27; 95% CI, 0.08-0.84 for annual household income <$40 000 vs ≥$80 000). The low IGF1 group (z score ≤ -2) experienced significantly higher prevalences of various adverse outcomes compared to the normal IGF1 group (z score >0), including various neurocognitive impairment (eg, verbal reasoning [OR 2.79; 95% CI, 1.95-3.98]), diminished health-related quality of life (eg, physical functioning [1.97; 1.35-2.86]), abnormal glucose metabolism (1.82; 1.21-2.71), and abnormal fat percentage (3.16; 1.98-5.26). CONCLUSION: Untreated aGHD potentially contributes to multidimensional adverse outcomes, and GHT may provide health benefits among survivors, though socioeconomic disadvantage may limit their access to GHT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".