"Height anxiety" is not desirable. Growth hormone is not a "panacea".

"Children's height" is an important health indicator that many parents pay attention to. Some parents use standard height reference and other data to judge whether their children's growth and development are normal. If a child's height is lower than the standard, it will cause anxiety for parents. Therefore, in the endocrine clinic of a children's hospital, many parents often bring their children to see a doctor, hoping to promote their children's height through the "external force" of injecting growth hormone.

Recently, Song Fuying, deputy chief physician of the Department of Endocrinology at the Children's Hospital Affiliated to Capital Institute of Pediatrics, was interviewed by "Yun Ting Yun Yi" and answered questions about growth hormone that parents are generally concerned about.

How to determine whether a child is short?

Song Fuying said that doctors will make judgments based on comprehensive factors such as the child's growth rate and genetic height difference. The growth rate is divided into different age groups: less than 7 cm per year for children under 3 years old; less than 5 cm per year from 3 years old to puberty; less than 6 cm per year after entering puberty. If such a growth rate occurs, parents should take their children to see a doctor in time.

After the consultation, the doctor will conduct a comprehensive examination of the child, including growth hormone-related sports screening and growth hormone stimulation experiments. In addition to growth hormone factors, the diagnosis can also be confirmed through blood tests for thyroid hormones, electrolyte disorders, anemia and other comprehensive factors. If growth hormone deficiency is confirmed, the doctor will recommend medication.

In addition to childhood growth hormone deficiency, the FDA-approved indications for growth hormone also include idiopathic short stature, SGA (small for gestational age) continued growth retardation after birth, chronic renal insufficiency before kidney transplantation, Turner syndrome, Prader-Willi syndrome, short bowel syndrome and other diseases that cause short stature. If a child's disease falls within this range, growth hormone can be used only if it is necessary after a strict evaluation by a doctor.

Song Fuying introduced that currently growth hormone can be injected once a week. Compared with the daily injection of short-acting growth hormone, it ensures injection compliance, reduces children's pain, and also ensures efficacy.

Side effects of growth hormone

In response to parents' concerns about side effects, Song Fuying also gave an answer, "Some side effects of growth hormone injection may occur, including local transient reactions at the injection site (pain, numbness, redness and swelling, etc.), joint pain, myalgia and headache. Scoliosis, mild increase in liver function transaminase, etc."

If the side effect of hypothyroidism occurs, Song Fuying said that in fact, this is not a side effect of growth hormone, but the body's own lack of thyroid hormone, which is more common in multiple hypopituitarism. When growth hormone is deficient, "hypothyroidism" does not show up. After taking the medicine, the body enters a period of rapid growth, which also shows the original hypothyroidism. The doctor will recheck the thyroid function after treatment. If the problem is found, take medicine early, and it can be controlled.

"Some problems require timely follow-up and adjustment of treatment plans during the medication process, and the use of growth hormone cannot be abused. Again, it is necessary to understand the indications of growth hormone and communicate fully with parents." Song Fuying said.

At the same time, Song Fuying also reminded that some children may experience abnormal blood sugar levels during medication. This is because from the mechanism of action of growth hormone, it is a glucose-raising hormone that will cause blood sugar to rise. Growth hormone treatment does not increase the incidence of diabetes in most cases, but it may advance the onset of type 2 diabetes to adolescence and childhood. Doctors will regularly review glycosylated hemoglobin, blood sugar, insulin and C-peptide. If blood sugar rises, the medication can be discontinued for observation as appropriate. In theory, blood sugar will return to normal after discontinuation of the medication.

How to grasp the peak of children’s growth hormone secretion?

Summer is the golden period for children to grow taller, so parents should not ignore this critical stage. Song Fuying reminds parents that growth hormone is secreted in a pulsed manner, with 6-8 peaks every day. Parents can grasp the timing of their children's growth hormone secretion to help their children grow better. Pay attention to the following points:

1. Make sure your child falls asleep before 10 o'clock. Deep sleep can promote the secretion of growth hormone.

2. Ensure exercise. Exercise can promote the secretion of growth hormone, which is also used for screening of growth hormone deficiency. Encourage children to do more vertical exercises, such as skipping rope, playing basketball, etc.

3. Avoid obesity and malnutrition. The former leads to a lower peak growth hormone level, and the latter leads to insufficient production of growth factors, both of which may cause lifetime height to be lower than genetic.

Source | Yuntingyunyi, Capital Institute of Pediatrics Popular Science Account