During the past summer vacation, it was hard to find the No. 1 seat in the endocrinology departments of major children’s hospitals. Many parents who were worried about their children’s height hoped to use “height increasing needles” to make their children grow taller quickly. However, the cost ranging from tens of thousands to hundreds of thousands also discourages many people.
On August 4th, Xinhua News Agency issued a risk warning on “height-enhancing injections”, saying that this growth hormone has signs of being abused, which may cause endocrine disorders, femoral head slippage, spinal cord injury, etc. Health risks such as side bending. Previously, there were media reports that some medical representatives even used high rebates to lure pediatricians to overprescribe drugs due to the huge profits behind the “increased needles”.
Between worries about their child’s height and the possible side effects of the injections, Chinese parents are once again caught up in anxiety.
Parents generally respect their children I feel anxious about my height
“My eldest daughter is 13 years old and is in the first grade of junior high school. She is 1.6 meters tall, my husband is a little over 1.7 meters, and I am 1.66 meters. According to the previous standards , this child is not short, but she is one of the bottom ten girls in the class. Can I worry about how to increase her height? On September 8, she was waiting for outpatient service at the Department of Endocrinology, Children’s Hospital Affiliated to Capital Institute of Pediatrics A mother said that children are well nourished, develop early, and are generally taller than the previous generation. She hopes that her daughter will grow to at least 1.7 meters.
A couple from Baoding with a 4-year-old Ban’s son came to see a doctor. His son’s height was just over 0.9 meters. “There is no problem with eating, but he doesn’t grow up. In the hospital in Baoding, he was injected with growth hormone, and we will have experts in Beijing take a look. “
“Chinese Resident Nutrition and Chronic Disease Report (2020)” shows that the average height of men and women aged 18-44 in China is They are 1.697m and 1.58m. Although 1.6m has exceeded this standard, parents are not satisfied with their children’s height.
Occasionally, many parents who have been in contact with them think that past experience and “average height “As a standard. Children who are taller will not only be more confident, but also have a great impact on their future careers. Because dance, flight attendant law, teacher training, military police and other majors require tall heights and one or two centimeters shorter in the college entrance examination You may miss valuable opportunities.
In 2014, “People’s Daily” revealed that the incidence of short stature in children in China is about 3%. There are about 7 million children aged 4-15 who need treatment, and the actual Fewer than 30,000 patients have received reasonable treatment.
Summer vacation is the peak season for children to see a doctor. According to Xinhua News Agency, Dr. Lin Ming from the Pediatric Endocrinology Department of Wuhan Union Medical College Hospital revealed that during the summer vacation, he would visit the doctor every week. Received more than 320 patients. 2008On August 13, City Express reported that the Department of Endocrinology of Zhejiang University Children’s Hospital has 600 to 700 outpatients per day, and it is estimated that more than 30,000 people will be treated in one summer vacation.
Similarly, in Jiangxi, “Jiangnan Metropolis Daily” stated that the Pediatric Children’s Growth and Development Center of the Second Affiliated Hospital of Nanchang University received 70-90 patients every day during the summer vacation. A child who has entered puberty is 1.75 meters tall, but the parents think that the children of relatives are all over 1.8 meters tall, and want to use growth hormone to “strengthen the seedlings”.
Ms. Su’s height felt anxious. In 2018, Susu, who was more than 7 years old, was only 1.2 meters tall, making her the shortest girl in her class. The hospital checked that her bone age was 9.2 years old, which was 1.6 years different from her age. The predicted height is less than 1.5 meters.
Ms. Zhang told me that occasionally it will be cured. She was really panicked at that time. Doctors recommend immediate growth hormone therapy. After 10 examinations, no other diseases were found, and the pituitary gland secreted hormones normally. I followed the advice of other doctors to observe first, and urged the child to go to bed early, skip rope, stretch, etc. Every day, and add various vitamins and meat, eggs, milk. Because of their height, mother and daughter often quarrel.
In March this year, Susu was more than 1.4 meters tall. The bone age of the hospital examination was 11 years old, which was only 4 months older than her actual age. The predicted adult height is close to 1.6 meters, which is almost the same as the genetic target height. Ms. Zhang breathed a sigh of relief, but her anxiety was still there, because the girls of the same age in Susu’s class were developing very fast. Most of the girls were close to or even over 1.5 meters tall when they were 11 years old, and Susu was the shortest girl.
For parents’ anxiety, Wu Wanshui, chief physician of pediatrics at Beijing Shijitan Hospital, said that for children, good living habits are conducive to the growth of height, including good sleep, exercise, especially jumping exercise, and balanced nutrition , in a good mood.
In addition, parents should know that growth hormone does not necessarily make you grow taller when you use it. Growth hormone may need to function through growth hormone receptor, IGF-1, growth hormone binding protein, etc. , and any problem in any of these links may affect the effect of growth hormone. During treatment, the body produces antibodies to growth hormone, which also weaken its effects. Nutrients cannot meet the growth needs of the body, and will also affect growth and development.
If you want to increase, please call
the doctor mentioned in the articleGrowth hormone, commonly known as “increasing needle”. It was born in 1956. Raben, an endocrinologist in Boston, USA, isolated and purified growth hormone (hGH) from human pituitary gland, and applied it to the treatment of growth hormone deficiency (GHD). Domestic growth hormone powder was launched in 1998, and domestic aqua was launched in 2005. The manufacturer is Kinsey Pharmaceuticals, a subsidiary of Changchun High-Tech.
In the story of the growth hormone “Shen Feng”, the world-famous star Messi is mentioned the most. At the age of 1, Messi was diagnosed with idiopathic short stature. Doctors thought he could only grow to 1.5 meters, but Messi finally reached 1.7 meters through injections of growth hormone, which laid the foundation for his football career.
Growth hormone can only be used to treat growth hormone deficiency, idiopathic short stature, etc. , Do not arbitrarily expand the scope of treatment. In Xinhua News Agency’s “Height Anxiety”, did you get the “enhancer”? Danger! In the report, Xu Xuan, a pediatric endocrinologist at the Hunan Provincial People’s Hospital, said that some parents feel that their children are not tall, so they want to get booster injections and use booster products.
On September 8, when she walked out of the special clinic of the Endocrinology Department of the Children’s Hospital Affiliated to the Capital Institute of Pediatrics, Yuanyuan’s mother was in a tangle. Yuan is 10 years old and 1.45 meters tall. Although it exceeded the normal standard of the children’s height comparison table in the hospital, the bone age showed 12 years old. The genetic target height is 1.6 meters, and the predicted height is 1.56 meters according to the bone age.
“The child is about to have a period, and puberty will be slow. If he doesn’t get an injection, the bone scale line may It will close. Yuanyuan’s mother told her that it will be cured occasionally, but she can’t make up her mind. She wants her daughter to be 4 centimeters taller, but she is afraid that her daughter will take unknown risks. She is still weighing whether it is worth buying a few centimeters for more than 100,000 yuan.
Xiaojie from Beijing was in a hurry when her son was in sixth grade. She was 1.7 meters tall, her husband was about 1.8 meters tall, and her son only grew 1.5 centimeters in one and a half years. The height of 1.4 meters was the lowest in the class Going to the hospital for an examination, the anterior lobe of the son’s pituitary gland secreted insufficient growth hormone. The checklist showed that the “target height” exceeded 1.8m, but the predicted adult height was only 1.5m.
In September this year, Chu Xiaojie told “Occasionally Cure” magazine, his son had to get an injection. From the first to the third day of junior high school, he grew to 1.7 meters. After the doctor’s examination, he found that his growth hormone secretion had returned to normal, so he stopped the injection. This year her son is a freshman, and his height She is 1.83 meters tall. She is very satisfied with the treatment effect.
In fact, growth hormone injection is not a random injection.
Xinhua News Agency warned that only a very small number of children really need growth hormone treatment, most of them only require regular diet, exercise and sleep guidance.GHChildren with normal secretion cannot be injected, otherwise it will cause problems such as endocrine system disorders.
Doctors are generally cautious. Zhang Yining, director of the Department of Pediatric Endocrinology, Genetic Metabolism, Bethune No. 1 Hospital of Jilin University, believes that drugs are used to treat diseases. It’s not that I think I’m short, I can grow as tall as I want, it’s ridiculous.
Lin Ming of the Pediatric Endocrinology Department of Wuhan Union Medical College Hospital believes that children with short stature must undergo examinations such as bone age and growth hormone secretion level to rule out various diseases before deciding whether they are suitable for growth hormone treatment. Growth hormone is considered the most effective treatment for children with short stature.
Yang Wenqing, a pediatrician at the East Hospital of Sichuan Provincial People’s Hospital, said that some short stature is combined with some underlying diseases. After the underlying disease is cured, there may be catch-up growth. If it is short and there is no growth hormone deficiency, there is absolutely no need for growth hormone injections.
Take Strict inspection before growth hormone
In a regular hospital, there are many tests that need to take growth hormone.
Nanjing’s “Dust Mother” son is 10 years old this year. She recorded the inspection items for growth hormone with her son in 2019. Including measuring height and weight, bone age film. On the second day, we did fasting blood sugar, grandpa’s seven items, *** biochemistry, abdominal B-ultrasound, pituitary MRI, urine routine, blood routine, and electrocardiogram. An arginine challenge test and a clonidine challenge test were also performed.
28 days after the injection of growth hormone, the son’s height increased from 1.306 meters to 1.32 meters. It costs about 5,000 yuan per month. Before, her son had low self-esteem because of his short stature. Since he knew that injections can grow taller, he set the alarm clock to give himself injections every day.
Xiao Jie told him that he was cured by chance. At the beginning, his son also had various examinations and took aqua growth hormone. During the period, I went to the hospital for regular checkups, and adjusted the injection dosage according to the secretion of hormones in the body. One shot of 10ml was given for three days, and then one shot was given for one week.
Wu Wanshui, director of the Department of Pediatrics of Beijing Shijitan Hospital, introduced that occasionally he was cured. Before injecting growth hormone, it is necessary to fully understand growth and development, growth curve, bone age, estimated final height, etc. In addition to short stature caused by other diseases, understand whether there are contraindications, and monitor possible adverse reactions during diagnosis and treatment. For example, it is necessary to know whether there are thyroid diseases, adrenal gland diseases, tumors, genetic metabolic diseases, intracranial diseases (especially pituitary gland), nutritional deficiency diseases, precocious puberty, etc.
In order to ensure the safety of growth hormone injection, children should check about 20 items, includingIncluding bone age films, sellar area MRI, abdominal color Doppler ultrasound, growth hormone, thyroid function, routine hematuria, blood biochemistry, etc.
Wu Wanshui introduced that in the process of diagnosis and treatment, children with true growth hormone deficiency are rare, and most of them are short in stature, but they cannot meet the diagnostic criteria for short stature. The reasons are mostly heredity, nutrition (partial eclipse), disease, sleep and other factors.
Short stature does not mean growth hormone deficiency. There are many causes of short stature, such as congenital hypothyroidism, familial short stature, brain disease (especially hypothalamic involvement), severe malnutrition, delayed physical puberty, abnormal bone development, small for gestational age, congenital ovarian hypoplasia Wait. Some of them can use growth hormone, while others can’t.
According to Xinhua News Agency, Zhang Yining, director of the Department of Pediatric Endocrinology, Genetic Metabolism, Bethune No. 1 Hospital of Jilin University, believes that excessive inspections and irregular inspections are very common. When parents come to the clinic, they must do a growth hormone test for their children. The doctor said they would not use UF to do it, and they were scolded. There are many external factors affecting the hormone hormone levels at that time, and comprehensive judgment is required. Some hospitals use non-standard methods to conduct examinations, and start giving booster injections to children after the examination results come out, which is very irresponsible.
Grow Hormone has been exposed and questioned by the media many times
Growth hormone is undoubtedly an expensive drug. Ma Yuan told “Occasional Cure” that in addition to growth hormone, Yuan Yuan also had to take inhibitory injections to reduce the level of sex hormones and inhibit the rapid development of Youyou Resource Network. The doctor’s estimated cost is about 12,000 yuan per month.
According to the staff of a pediatric clinic near Guomao, a well-known pediatric endocrinologist from a hospital in Beijing will visit the clinic in person, where various examinations can be performed. Whether to take growth hormone injections depends on the doctor’s diagnosis based on the examination results, and does not necessarily prescribe medicine. The exact cost is different for each child.
The price of growth hormone published by the clinic shows that the price of long-acting growth hormone (Jin Sai Zeng) is 54 units, and the price is 4300 yuan. Water aqua each will increase by 30 units, 1031 yuan. (Note: Some drugs, such as vitamins, hormones and other biological products, have unstable chemical components or cannot be verified by physical and chemical methods so far. Biological experiments usually verify their effectiveness by comparing with standard products. Through this biological assay, certain biological The lower potency unit of potency is called “unit” (u); the internationally negotiated standard unit is called “international unit” (IU).)
According to Xinhua News Agency, there are also growth hormones in powder and waterLong-acting preparations. Due to different preparations, weight, and sensitivity, the monthly cost is between 3,000 yuan and 15,000 yuan, and it usually takes 2 to 5 years to inject.
Because the promotion of “strengthening injections” can make huge profits, some medical representatives use high kickbacks to lure pediatricians to overprescribe drugs. As early as June 2012, CCTV’s “Weekly Quality Report” broadcast “Abused Growth Hormone”. A 9-year-old child is 1.29 meters tall. The clinic doctor suggested growth hormone injections without any relevant examinations.
In fact, the proportion of patients who are truly diagnosed with growth hormone deficiency is not large. An analysis of the etiology of 523 short children in the Department of Endocrinology, Children’s Hospital Affiliated to Shanghai Fudan University showed that only 115 of them suffered from growth hormone deficiency, accounting for 21%. 99% of the total.
In 2014, Yeh, a retired professor of pediatrics at Xiangya Hospital of Central South University, exposed the inside story of “medical representatives trying to manipulate doctors to prescribe growth hormone indiscriminately”. Commission” encourages doctors to prescribe more growth hormone, and the commission is 10% of sales.
Pharmaceutical companies have various ways to evade supervision. For example, pharmaceutical companies “created” a unique drug sales model, that is, patients first see a doctor in a large hospital, and then the doctor guides the patient to buy drugs in a designated primary medical institution. “China Business Daily” disclosed this in 2019.
The Xinhua News Agency’s report on August 4 also shocked growth hormone pharmaceutical companies.
According to Shanghai Securities News, on August 5th, Changchun Gaoxin and Anke, which are mainly engaged in growth hormone Both creatures plummeted. In the interactive exchange on the Shenzhen Stock Exchange, Changchun Gaoxin replied that growth hormone is a prescription drug, and related products are sold to medical institutions that meet the requirements of laws and regulations. Pharmaceutical companies set up special agencies to collect the safety information of their products, analyze and evaluate the collected information, and continuously monitor product safety throughout the life cycle of drugs.
No Side effects and risks that should be ignored
In 2008, “Chinese Journal of Pediatrics” published “Guidelines for the Diagnosis and Treatment of Short Children”, which pointed out the common side effects of growth hormone therapy, including hypothyroidism, glucose metabolism Changes, idiopathic benign increased intracranial pressure, antibody production, slipped femoral head necrosis, local swelling or rash after injection, the possibility of inducing tumors, etc.
In addition, the current adverse reactions related to growth hormone therapy include benign intracranial hypertension, the impact of glucose metabolism, hypothyroidism, pigmented nevus, swelling of hands and feet, local redness, rash, otitis media, etc.
In the 2019 Banyuetan report, Xu Xuan, director of the Pediatric Endocrinology Department of Hunan Provincial People’s Hospital, suggested that many parents request booster injections for their children. If the child In the past, growth was slow, but growth accelerated after using growth hormone, and the child’s thyroid hormone demand will increase accordingly. Some children’s thyroid function will temporarily decrease, and symptoms such as fatigue, fatigue, and edema will appear. Some children will experience high blood pressure after injecting growth hormone. Blood sugar problems, so regular monitoring is required to avoid the risk of diabetes.
Peking Union Medical College Hospital Endocrinology Chief Physician Wu Xueyan said that some young people with closed epiphyseal injections of large amounts of growth hormone may cause extremities Hypertrophy and ugly appearance.
In a recent report in China News Weekly, Australian public health physician and child health researcher Xiaoshu Chen suggested that the use of growth hormone for idiopathic short stature in children and adolescents remains Controversial, there is no evidence that this therapy has a good effect on non-pathological short stature that is not deficient in growth hormone. The application scale of early growth hormone itself is too small, and in fact most of the drugs have been on the market for a short time, and cannot guarantee long-term The presence of side effects.
In the December issue of the Journal of the American Medical Association, pediatric endocrinologists at Karolinska University Hospital report that in children and adolescents Among 3,408 patients treated with recombinant growth hormone and followed for up to 25 years, compared with 50,036 untreated patients with similar other diseases, the risk of cardiovascular events such as heart attack or stroke was one-third higher in men Second, it is twice as high for women.
Because of concerns about the safety of growth hormone, some domestic official media pointed out that the use of growth hormone should be regulated. Health authorities should strengthen the training and supervision of doctors, and doctors should Strictly abide by the relevant guidelines for children’s diagnosis and treatment, and prevent clinical abuse and excessive use of growth hormone. Departments of health, drug supervision, and public security must form a joint effort to severely investigate and deal with illegal acts of profit-driven induction of growth hormone injections in children.
1. People’s Daily Online, March 25, 2014 “Seven million short children across the country Only 30,000 treatment experts call for joint efforts to solve the problem”
2. City Express August 13, 2021 “Parents are too anxious about their children’s height”
3. Jiangnan Metropolis Daily September 2021 “Growing by injection? Be careful to pull seedlings to encourage growth.
4. Jiemian News, June 2, 2021 “Behind the hidden worries of collection, growth hormone grows by “abuse”?”
5. Macy’s China documentary, https://v.qq.com/x/page/k3127ekvcia.html?
6, 7, 8. August 4, 2021, Xinhua News Agency, “Should I Get a “Height Injection” When Anxious About Height?” Danger! “
9. CCTV Weekly Quality Report, June 3, 2012
10. Sanxiang Metropolis Daily, May 12, 2014 “Relief with Medicine” Doctors prescribe growth hormone indiscriminately”
11. “China Business News” July 6, 2019 “Behind the 5.6 billion capital: the pain of excessive sales of growth hormone in Changchun Hi-Tech”
12. On August 5th, there are resources on the official WeChat official account of Shanghai Securities News, “Changchun High-tech, Anke Biology plummeted! “Raising the pointer” treatment trigger”
13. Guidelines for the diagnosis and treatment of short children, Chinese Journal of Pediatrics, 2008, 46(6)428-430.
14. Ban Yue Tan 2019. 8. 26 “Inducing excessive injection and increasing needles, medical representative “latent””
15. “China News Weekly” September 4, 2021 “Compared to short stature, who cares about the side effects of increasing injections? “
16. On April 2, 2021, use growth hormone to help children grow taller? You should be more careful”
https://cn.nytimes.com/health/2021 04 02 /growth-hormone-short-child-height/
Author: Li Hualiang
Producer: Li Chen
One of the picture sources: Zhanku Luohai
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