With the improvement of people’s living standards, childhood dwarfism has become an important issue of concern for many families and society, but this does not mean that parents have taken the right approach after finding out that their children are short in stature. Many parents indiscriminately abuse various “height increasing” drugs because their children are short, and some parents expect their children may “grow up later” and blindly wait until their children are already high school students, or even college students, because of schooling and employment. At that time, the child’s epiphysis is close to or has already closed, and the growth potential is very limited, thus missing the best time for treatment. Therefore, early detection, early diagnosis and early treatment of short stature are especially important.
So, what is considered short stature? Generally speaking, a child whose height is below the third percentile or two standard deviations (national standard) of the height of a normal child of the same age, sex, region or race, and whose growth rate is less than 4 cm/year during childhood, is considered to be short in stature.
Common causes of short stature: 1. Endocrine diseases such as pituitary dwarfism, hypothyroidism and precocious puberty.
Pituitary dwarfism (i.e. growth hormone deficiency) is the most common, mainly manifesting as proportional dwarfism, childish face and normal intelligence, often accompanied by gonadal dysplasia such as small penis, cryptorchidism and urolithiasis, etc. Most of these children have delayed puberty.
Thyroid hormone is an important hormone that promotes growth and development. Children with hypothyroidism often suffer from delayed growth and lagging behind due to the lack of thyroid hormone, often accompanied by mental retardation.
Precocious puberty is a common disease that causes short stature. Due to the early secretion of a large amount of sex hormones, the growth rate at the beginning is significantly faster than that of children of the same age and sex, and the height increases significantly, but due to the stimulation of sex hormones, the bone age oversteps, the epiphysis closes early, and growth stops early, which eventually leads to short stature in adulthood. In another case, although it is not precocious, but the development is early, it shows that the body is tall in the class when you are in elementary school or junior high school, but in late junior high school or after high school, the growth rate is obviously slowed down.
2. Chromosomal diseases such as Turner syndrome (also known as Turner syndrome, congenital ovarian insufficiency syndrome) are the more common diseases that cause girls to be short. The main manifestations are short stature, short neck, webbed neck, dark skin nevus, no pubertal development of sexual characteristics and primary amenorrhea, etc. However, there are atypical children who only show short stature. In other cases, such as congenital dwarfism and glycogen accumulation disease, in addition to short stature, they are often associated with mental retardation, special physical appearance and appearance.
Skeletal disorders such as chondrodysplasia, osteogenesis imperfecta, renal tubular acidosis, anti-vitamin D rickets, etc., all these children have obvious skeletal developmental deformities, special physical appearance and non-proportional dwarfism.
4, intrauterine growth retardation Due to insufficient nutrition or oxygen supply during maternal pregnancy, placental disease, intrauterine infection, fetal genetic abnormalities and other factors leading to intrauterine fetal growth retardation. The birth weight is small, generally less than 2.5 kg, and about 1/3 of these children will be short in stature when they become adults.
5. Idiopathic short stature These children have no obvious foci in hypothalamus and pituitary gland, but the growth hormone secretion function is insufficient, and the cause is not yet fully understood.
6.Familial short stature The growth rate is not less than 4 cm/year, the bone age is comparable to the actual age, and the intellectual and sexual development is normal.
7. Somatic delay in puberty It is a variation of normal development and is more common in boys. It shows no abnormal growth at birth and for several years after birth, but later the growth rate becomes slow, especially before puberty or when it is about to enter puberty, the sexual development is delayed, and the bone age is also behind, but parallel to the growth, that is, the real late development. One or both parents have a similar situation, the final height is not affected.
8. Chronic diseases and long-term malnutrition Severe chronic diseases such as heart, liver and kidney, long-term malnutrition and mental and psychological depression can also affect growth and development.
Short stature can be caused by a variety of causes, for different causes should take the appropriate treatment, do not blindly use drugs and delay the treatment. Parents are reminded to pay attention to three points: Is the child short? What is the cause of the child’s short stature? Is it treatable?
Treatment of short stature: At present, there are three main types of treatment methods: 1. Growth hormone supplementation. 2.
2.Bone lengthening surgery.
3. Health care products.
The efficacy of the various types of health supplements currently available on the market is uncertain, and although bone lengthening can increase the height of children whose epiphyses have already closed by another 5-7 cm, the surgery is painful and risky, and the post-operative side effects are unpredictable. Growth hormone is mainly used for short stature caused by growth hormone deficiency, Turner syndrome, intrauterine growth retardation and idiopathic dwarfism, and is an effective drug. The clinical effect of growth hormone in the treatment of dwarfism depends on the age of initiation of treatment, bone age and nutritional supply. Generally, the younger the age of starting treatment, the better the effect. If the child’s bone age increases due to the abuse of other drugs, the treatment effect will be significantly affected. The course of growth hormone treatment generally lasts until the epiphysis is fused, and should be checked every 3 months during this period.
In addition to medication, reasonable nutrition, proper exercise and sufficient sleep are necessary to promote growth and development. Adequate nutrition is an important material foundation, so we should pay attention to scientific feeding and balanced diet; exercise can promote the secretion of growth hormone, especially bouncing can stimulate bone growth, so children should do more outdoor activities; adequate sleep is one of the necessary conditions for growth, because the peak secretion of growth hormone occurs after sleeping, so adolescents in the growth period should arrange time reasonably and try not to stay up late.