Causes:
Suppress GH and IGF-1 action at the growth plate
- slow linear growth with weight gain acceleration
Glucocorticoid excess
In hypothyroidism:
- in addition to typical symptoms you will also see profound growth deceleration/failure and __ puberty
Delayed
Most important in the first few months (up to about 9 months) when it comes to postnatal growth
Nutrition
Secretion affected by:
GH
Newborns with congenital hypothyroidism or growth hormone deficiency are usually __ at birth
Normal size
Disorders of the GH-IGF axis
Other endocrine disorders:
Malnutrition
IUGR
Chronic diseases
Psychosocial disorders
Secondary Growth Disorders
Growth hormone action:
Make __ into lean tissue
Adipose tissue
Hormone that leads to:
Estrogen
At midgestation, fetus grows how much per week?
2.5 cm
Growth hormone action at the level of __:
Muscle
Hypothalamic dysfunction –> impaired GHRH release
GH deficiency
Binding of what molecule to its receptor at the bone level leads to growth
Synthesized in the liver
IGF-1
In secondary growth disorders:
- linear growth is __ throughout
Skeletal age (bone age) __ chronologic age
Slow
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Endocrine regulators of growth
- local production critical for normal intrauterine growth
Prenatal role in humans not completely delineated
- mice with knockouts have birth weights 60% of normal
IGF-1 and IGF-2
Definition:
Short stature
Critical mediator of growth
- rises significantly during puberty
Largely responsible for stimulating muscle and cartilage growth
IGF-1
Children grow in a remarkably __ manner
Any deviation from this pattern should raise concern
Predictable
Secreted in a pulsatile manner, greatest amplitude overnight
Regulated by:
Secretion affected by:
GH
Peak growth rates occur during the __ __ of life and during puberty
First year
The major endocrine regulator of fetal growth
- infants of diabetic mothers are born large bc glucose crosses placenta
Insulin
3 phases of growth
Girls: ((Dad’s height - 5 inches) + mom’s height)/2
Boys: (Dad’s height + (mom’s height + 5 inches))/2
Mid parental height
Idiopathic short stature:
Genetic or familial short stature is cases in which bone age __ chronological age
Constitutional delay of growth and puberty (late bloomers) is cases in which bone age __ chronological age
=
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What kind of growth chart do you use for 2-20 year olds?
CDC