I. What is short stature? Children from 2 years old to prepubertal can calculate normal height by the formula: age × 7 + 70 (cm). A child who is 2 standard deviations below normal height (about 6-7% of normal height) or whose height is lower than the 3rd percentile of the growth curve of children of the same age and gender (in layman’s terms, a hundred children of the same age and gender are lined up according to their size, and the last three are short) is called short stature.
What are the causes of short stature? Endocrine, disease, genetic and nutritional factors can cause short stature, among which the most common causes are growth hormone deficiency and precocious puberty. Of course, exercise, sleep and mental factors are also related to the growth of height.
First of all, you should go to the children’s endocrinology specialist or dwarfism specialist in a regular hospital for relevant examination, to distinguish the causes and do targeted treatment. There are more than 300 kinds of diseases known to be related to short stature, and it is undoubtedly terrible to take medicine without distinguishing the cause. Some height enhancement drugs on the market contain sex hormones, which are suspected of “boosting growth” and can promote the early fusion of epiphysis (bone growth line), leading to premature stoppage of bone growth and eventual decrease in height.
The first step is to take an X-ray of the left hand to understand the bone age and make an annual height prediction. Usually, when the bones are developing normally, the bone age and the age are approximately equal. If the difference between bone age and age is large or the predicted height is too low, the cause should be actively sought. Bone age greater than age (e.g., 10 years for an 8-year-old child) is most often due to precocious puberty and hyperthyroidism. If the bone age is younger than age (e.g., 6 years old in an 8-year-old child), it is most likely due to growth hormone deficiency and delayed sexual development. And check whether the epiphysis has closed, if it has closed then no more growth is possible. Then do growth hormone stimulation test, check thyroxine, sex hormones, chromosomes (some girls), etc. Before applying growth hormone, it is usually also necessary to check blood routine, head CT or MRI, blood sugar, liver and kidney function, etc., and IFG-1 when available. V. When is the most appropriate treatment for short stature children The earlier the treatment, the better the effect. For early detection, in addition to comparing height with children of the same age, we should also pay attention to the growth rate of children in general. Less than 4~5 cm per year from 3 years old to puberty, and less than 5.5~6 cm per year during puberty is considered as growth retardation, and we should go to the hospital for examination and consultation with a specialist in time. For example, the growth rate of girls’ height starts to slow down after the age of 12, and decreases to 1~2 cm per year after the age of 14, and women generally grow 5~7 cm on average after menarche. Once puberty is over, the epiphysis closes and no more growth is possible. Of course, premature use is also inappropriate, normal people in different growth stages, growth regulation is not the same.
Before the age of 1 year, the growth is regulated by the metabolic axis, and after the age of 1 year, it gradually transitions to growth hormone regulation (thus people with growth hormone deficiency are often not short before the age of 1 year), and above the age of 2 years, growth hormone regulation is the main focus, and very few people need to be completely regulated by growth hormone until around the age of 3 years. It is better. At too young an age, there are also problems with the difficulty of examination and the child’s lack of cooperation, and it is generally easier to start treatment at the age of 5-6 years.