As parents pay more and more attention to children’s height, more and more parents are taking their children to test growth hormones in outpatient clinics, and a group of children with growth hormone deficiency have also been found. For children with growth hormone deficiency who want a satisfactory height increase, the only solution currently is to use growth hormones reasonably and in sufficient amounts. But once we heard that we need to use growth hormone, parents have retreated, and they are full of doubts. There are more than N problems. Today we will talk about the problem of growth hormone.

About growth hormone, read this article is enough

What is growth hormone?

Growth hormone is a natural hormone secreted by the body itself. It is a protein secreted by the anterior pituitary gland. Its main function is to promote bone and muscle growth, and also accelerate the burning of body fat. Human growth hormone secretion is affected by gender, season, and circadian rhythm. Generally, growth hormone is secreted most during sleep at night, and secreted during the day is reduced. The growth hormones we use in the clinic are all recombinant human growth hormones produced by gene synthesis, and their structure is exactly the same as the body’s own secretion.

About growth hormone, read this article is enough

Can growth hormone only be injected?

Growth hormone is essentially a protein, so if it is administered orally, it will be decomposed and inactivated by the digestive juice of the digestive tract, so that it will not play a role in promoting growth. The subcutaneous injection of growth hormone is directly absorbed through the capillaries under the skin, and will not be affected by the digestive juice. It can still maintain its activity, so the growth hormones we currently use in clinic are all given by subcutaneous injection. Of course, with the development of drugs, there will be long-term growth hormone once a week or even once a month for clinical use, and there will also be continuously developed growth hormone inhaled through the nasal cavity.

About growth hormone, read this article is enough

How to judge a child’s growth hormone deficiency?

The secretion of growth hormone in the human body exhibits pulsed secretion, that is to say, similar to the wave-like secretion, there are peaks (secretion peaks) and troughs (secretion troughs). The difference between the troughs may be tens or even hundreds of times, so it is impossible to judge whether the growth hormone is secreted more or less based on the value of a blood test in the morning. Therefore, it is necessary to make a judgment on the growth hormone provocation test of the child.

The principle of the so-called provocation test is to use some drugs to encourage the body to accelerate the secretion of growth hormone itself, so that the growth hormone secretion stimulated by the drug will have a certain rule according to the time of the action of the drug. Determine whether growth hormone is lacking. At present, the commonly used growth hormone challenge tests include hypoglycemia excitation test, clonidine challenge test, arginine challenge test and levodopa challenge test. Because any kind of challenge test will have a misjudgment of about 15%, it needs to be used. Two different excitation tests are used to verify.

If the highest value of growth hormone detected in the challenge test is ≥10 ng / mL, then the child’s growth hormone secretion is completely normal; if the highest value is ≤5 ng / mL, then the child’s growth hormone is completely lacking; Between 5 ~ 10 ng / mL, it means that the child’s growth hormone is partially lacking. Growth hormone therapy is best used for children with complete or partial deficiency of growth hormone.

About growth hormone, read this article is enough

How to use growth hormone? How long will it take?

For children with growth hormone deficiency, the recommended dose of growth hormone is 0.1 to 0.15 U / kg body weight per day, and the calculated daily dose will be injected subcutaneously once a day. Because growth hormone is the peak secretion during sleep at night, the injection of growth hormone is also taken every night before going to bed.

From the perspective of pathogenesis, growth hormone should be used for children with growth hormone deficiency for a long time until the child’s epiphysis is closed. But in fact, on the one hand, growth hormone drugs are currently more expensive, and the monthly cost is mostly 3,000 to 6,000 yuan. Some obese children even need 10,000 yuan per month; on the other hand, as the duration of continuous injections increases, The role of growth hormone in promoting height growth will gradually weaken, so in most cases, it is clinically recommended to use it continuously for 1 to 3 years. If you use it continuously for less than 1 year, you cannot fully see the effect of growth hormone on promoting height growth. After all, the growth cycle of the human bone itself also takes 3 to 4 months.

The age of initial growth hormone therapy is currently considered to be 5-7 years old. The main reason is that on the one hand, children under the age of 5 may not cooperate well with parents ’injections, and parents are also likely to interrupt injections because their children cry. Growth hormone must play a role in promoting height growth before the child’s epiphysis closes, and as the child’s age increases, the growth-promoting effect of growth hormone will weaken, that is to say, the effect of 7-year-old children for 3 consecutive years of growth hormone will definitely The effect of using it continuously for 3 years than a 10-year-old child. From this perspective, it also tells us that growth hormone deficiency should be diagnosed early and treated early, and early diagnosis depends on the parents’ annual observation of the child’s height growth.

About growth hormone, read this article is enough

What are the side effects of growth hormone?

Growth hormone is the only safe and effective drug approved by the US FDA for the treatment of short stature. After more than 30 years of extensive clinical observations, the European Society of Pediatric Endocrinology officially announced in 1993 that recombinant human growth hormone has very good safety in routine replacement therapy. The gene recombinant auxin currently in clinical use is exactly the same as the growth structure secreted by human pituitary, and the auxin produced by secretory expression technology is a product with higher quality and purity, which is safer and more effective. Various reports at home and abroad: There is no evidence to prove that the long-term use of recombinant human growth hormone will promote the risk of leukemia, brain tumor recurrence and diabetes. There is also no evidence to prove that when using human growth hormone during general medical diseases (such as colds, fever, diarrhea, etc.), the medicine must be discontinued.

Some parents react to the symptoms of itching, pain, fat hyperplasia, and fat atrophy caused by the injection of growth hormone in their children. This is related to parents not mastering the correct injection method, not strict skin disinfection, and inconvenient replacement of injection needles. A very small percentage of children will have increased liver function after starting growth hormone injection. This is because after starting growth hormone treatment, they will mobilize the child’s own liver function to cooperate with the role of growth hormone, and it will generally recover automatically. If the liver function increases seriously It is necessary to use hepatoprotective drugs and conduct detailed inspections. Some children will have transient high blood sugar, which can be improved through a healthy diet and exercise. There are also a small number of children who will have transient hypothyroidism. If serious, you need to be treated with alternative drugs. Most of the above transient changes will gradually adapt after using growth hormone. Even if they cannot fully return to normal, they can be cured by a certain treatment. In addition, it is reported that children who use growth hormone will have subluxation of the femoral head, which is related to the increase of joint cavity fluid caused by growth hormone. It can be found and avoided early through regular follow-up inspection.

All in all, for children with growth hormone deficiency, early diagnosis, adequate use, and adherence to follow-up, so that the effective role of growth hormone can be fully exerted, and the child has an ideal height.