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接受促性腺激素释放激素激动剂治疗的泰国性早熟女孩的骨矿物质密度和身体成分

Bone mineral density and body composition in Thai Precocious Puberty girls treated with GnRH agonist.

作者信息

Wacharasindhu Suttipong, Petwijit Thaninee, Aroonparkmongkol Suphab, Srivuthana Sumarlee, Kingpetch Kanaungnit

机构信息

Department of Pediatrics and Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2006 Aug;89(8):1194-8.

Abstract

Treatment of true Precocious Puberty (PP) with GnRH agonist can improve final adult height by suppressing gonadotropin and sex hormone levels that delays the fusion of long bone epiphyseal growth plates. However, deprivation of estrogen may affect the acquisition of peak bone mass, especially in individuals with low calcium intake. Ten Thai girls with idiopathic true PP were evaluated for Bone Mineral Density (BMD) and body composition by DXA scanner (Hologic, Inc) before and after GnRH agonist therapy for 1 year. During treatment, all children were allowed to consume a normal diet without extra calcium supplementation. In addition, serum calcium, phosphate, alkaline phosphatase and osteocalcin were also measured. The results showed that GnRH agonist could improve predicted adult height from 149.4 +/- 5.4 to 153.6 +/- 6.8 cm (p < 0.001). Serum osteocalcin, representing the bone marker formation, decreased from 184.2 +/- 66.7 to 108.6 +/- 35.3 ng/mL (p = 0.012) However, the treatment had no negative effects on BMD lumbar spine and total BMD but increased percentage of fat mass from 25.7 +/- 5.2 to 31.6 +/- 5.5%. (p =0.007). In conclusion, treatment with GnRH agonist in Thai girls with true PP for 1 year can improve PAH without negative effects on BMD but a longer period of treatment needs to be studied.

摘要

用促性腺激素释放激素(GnRH)激动剂治疗真性性早熟(PP),可通过抑制促性腺激素和性激素水平来延缓长骨骨骺生长板的融合,从而提高最终成人身高。然而,雌激素缺乏可能会影响峰值骨量的获得,尤其是在钙摄入量低的个体中。对10名患有特发性真性PP的泰国女孩在接受GnRH激动剂治疗1年前后,通过双能X线吸收仪(Hologic公司)评估骨密度(BMD)和身体成分。在治疗期间,所有儿童均允许正常饮食,无需额外补充钙。此外,还测量了血清钙、磷、碱性磷酸酶和骨钙素。结果显示,GnRH激动剂可使预测成人身高从149.4±5.4厘米提高到153.6±6.8厘米(p<0.001)。代表骨标志物形成的血清骨钙素从184.2±66.7降至108.6±35.3 ng/mL(p = 0.012)。然而,该治疗对腰椎骨密度和总骨密度没有负面影响,但脂肪量百分比从25.7±5.2增加到31.6±5.5%(p = 0.007)。总之,用GnRH激动剂治疗泰国真性PP女孩1年可改善预测成人身高,对骨密度无负面影响,但需要研究更长时间的治疗情况。

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