I. Definition
Short stature refers to individuals of the same race, sex, and age who are less than 2 standard deviations (-2 SD) of the mean height of the normal population, or less than the 3rd percentile (-1.88 SD) in similar life circumstances
II. Indications
ü Height below the normal reference value of -2 SD (or below the 3rd percentile)
ü Bone age more than 2 years below the actual age
ü Height growth rate below the 25th percentile (by bone age)
n Children < 2 years of age (< 7 cm/year)
n Children aged 4.5 years to adolescence (< 5 cm/year)
n Adolescents (< 6 cm/year)
ü Children with clinical signs of endocrine disorders or dysmorphic syndromes
ü Other reasons for pituitary function tests
III. Test method
Test drug method Blood collection time
Insulin stimulation test 0.075u/kg(v) 0, 15, 30, 60, 90, 120
Measurement Blood glucose, GH, F
GHRH 1-2ug/kg(v) 0, 30, 60, 90, 120 Measure GH
Arginine 0.5g/kg(v) as above
(Maximum amount ≤ 30g)
Colistin 4ug/kg po. ditto
L-Dopa 10mg/kg P0. ditto
(Maximum quantity ≤500mg)
Pyridostigmine 1mg/kg po. ditto
L-Dopa+pyridostigmine ditto (recommended)
IV. Judgment of results
GH peak < 5 μg/L (complete GHD)
5-10 μg/L (partial GHD)
>10 μg/L (GHD excluded)