Clinic opening

Growth during childhood and adolescence is natural, but the timing and pattern vary from person to person. In addition, growth-related diseases or pediatric endocrine diseases that accompany these diseases require individualized systematic diagnosis and treatment for each patient by professional medical staff. ‘Growth Clinic/Pediatric Endocrine Clinic’ provides treatment for pediatric endocrine diseases such as short stature and growth disorders, pubertal abnormalities such as precocious puberty, pediatric diabetes, obesity, and thyroid disease.

Are our children growing normally?

‘Height’ is an important issue for today’s children and adolescents and their parents. As appearance-centered culture spreads through broadcasting and the Internet, ‘height’ is becoming an essential element of an individual’s identity. In addition, many children and adolescents consider their ideal height to be much taller than the average adult height in Korea, and are not satisfied with their own height. Amid the flood of unverified information about growth, many people are worried about their children's height and are visiting growth clinics.

What is normal growth pattern and adult height?

Growth speed varies depending on age. When newborns are born, their height is usually around 50cm. From this time until about 3 to 4 years of age, it is called the first rapid growth period. During this period, cell division occurs actively and the child grows a lot. At around 4 years of age, the child grows to about 100cm, which is twice the height at birth.

From the age of 4 to 5, the child grows approximately 5 to 6 cm every year until puberty begins. And when puberty begins, a second growth spurt occurs, growing more than 6cm per year. During this period, the height increases significantly due to the action of growth hormones and sex hormones. During puberty, boys grow an additional 25 to 30 cm and girls grow an additional 15 to 25 cm before their growth ends. In Korea, men usually stop growing at the age of 17 to 18 and reach adult height, with an average height of 173 to 174 cm, while women stop growing at the age of 15 to 16, and the average height is 160 to 161 cm.

What is short stature?

Short stature refers to being below the 3rd percentile compared to the standard for gender and age, that is, being within the third in order of height among 100 children of the same gender and age. Typically, a man's adult height of less than 160cm and a woman's adult height of less than 150cm can be considered short stature.

What are the causes of short stature?

Because the causes of short stature are very diverse, the cause must be found before treatment. This is because treatment varies depending on the cause.

◎ Familial short stature: This is the most common cause of short stature in Korea. Some people have short parents, grandparents, relatives, etc., and although they grow steadily by more than 4 cm every year, they continue to fall on the short side and become shorter than the average height even when they become adults. ◎ Constitutional growth retardation: This refers to constitutionally delayed growth. Bone age is delayed by more than 2 to 3 years compared to actual age, and pubertal development begins about 2 to 3 years later than other children. There are many cases where one of the parents has a history of growing up late, and although the current height is small, growth continues until late and reaches normal height as an adult. ◎ Small-for-gestational age infant: If the birth weight is low due to various reasons (weight less than 2.5 kg when born full-term), 10 to 15% of babies are unable to catch up with growth, resulting in a short adult height. ◎ Turner syndrome: In women, a defect in the X chromosome causes short stature, no breast development, and no menstruation. ◎ Hormonal abnormalities: Growth hormone deficiency, hypothyroidism, and Cushing's syndrome also cause slow growth and short stature. ◎ Chronic diseases: Congenital heart disease, cancer, chronic lung disease, malabsorption due to intestinal disease, etc. ◎ Others: Short stature may also occur in cases of nutritional deficiencies or skeletal abnormalities.

It is important to manage factors that can affect growth. It is most important to create an environment that can reduce stress in children, along with proper and balanced nutrition, regular and consistent exercise, and a good night's sleep lifestyle from an early age.

What is growth hormone?

Growth hormone is a hormone secreted by the pituitary gland that not only promotes the growth of bones and cartilage in the body, but also promotes increased muscle mass through fat breakdown and protein synthesis. In principle, growth hormone has been proven to promote growth in cases of growth hormone deficiency, Turner syndrome, growth failure due to chronic renal failure, Prader-Willi syndrome, Noonan syndrome, etc., and is currently covered by insurance in Korea. In addition, it is known to be effective in cases such as cases where a child was born as a small child but is short due to failure to catch up with growth, or cases where the child is short for no particular reason (idiopathic short stature).

You should consult with a growth specialist to decide whether to treat with growth hormones. It is important to start treatment at the appropriate time, especially since it is difficult to expect effects after the growth plate has closed. In addition, growth hormones can usually be expected to have good effects only when administered for a long period of time, over a year, but there may be differences in treatment response depending on the individual.

What is precocious puberty?

Physically, when secondary sexual characteristics begin to appear, that is, when the size of the testicles increases to more than 4ml in men and when breasts begin to develop in women, puberty can be known to have begun. Precocious puberty refers to cases where this pubertal phenomenon occurs before age 8 in girls and before age 9 in boys.

When puberty begins early, the physique is generally larger than that of children of the same age. However, sex hormones secreted with puberty cause the growth plates necessary for bone growth to close early, shortening the period during which growth is possible, which can ultimately result in shorter adult height. In this case, when a growth plate test is performed to measure bone age, it is found to be older than one's age. Additionally, because the body develops faster than others, various mental problems may arise.

What is the treatment for precocious puberty?

When diagnosed with precocious puberty, the most commonly used drugs are puberty inhibitors (gonadotropin-releasing hormone derivatives). Injections are usually given once every four weeks. After treatment, breasts become smaller and menstruation disappears in girls, and testicles decrease in size and penile erection and aggressive behavior decrease in boys. By administering a puberty inhibitor, the effect of delaying puberty and increasing final adult height can be expected.