Division of Endocrinology, Athens University Medical School, Aghia Sophia Children's Hospital, 11527 Athens, Greece.
J Clin Endocrinol Metab. 2010 Jan;95(1):109-17. doi: 10.1210/jc.2009-0793. Epub 2009 Nov 6.
The objective of the study was to evaluate the long-term effect of GnRH analog (GnRHa) treatment on final height (FH), body mass index (BMI), body composition, bone mineral density (BMD), and ovarian function.
SUBJECTS/METHODS: Ninety-two females, evaluated in adulthood, were categorized as follows: group A, 47 girls with idiopathic central precocious puberty (33 GnRHa treated and 14 nontreated); group B, 24 girls with isolated GH deficiency (15 GnRHa and GH treated and nine GH treated); group C, 21 girls with idiopathic short stature (seven GnRHa and GH treated, seven GnRHa treated, and seven nontreated).
FH, BMD, and percent fat mass of GnRHa-treated patients in all three groups were comparable with those of the respective nontreated subjects. BMI values of GnRHa-treated and nontreated subjects in groups A and C were comparable, whereas in group B, a higher BMI was found in subjects treated only with GH. Nontreated patients with ICPP had greater maximal ovarian volumes, higher LH and LH to FSH ratio, and more severe hirsutism than GnRHa-treated ones. Menstrual cycle characteristics were not different between treated and nontreated subjects. The prevalence of polycystic ovary syndrome in treated and untreated girls with ICPP was comparable, whereas in the entire cohort, it was 11.1% in GnRHa treated and 32.1% in the untreated (P = 0.02).
Girls treated in childhood with GnRHa have normal BMI, BMD, body composition, and ovarian function in early adulthood. FH is not increased in girls with ICPP in whom GnRHa was initiated at about 8 yr. There is no evidence that GnRHa treatment predisposes to polycystic ovary syndrome or menstrual irregularities.
本研究旨在评估 GnRH 类似物（GnRHa）治疗对最终身高（FH）、体重指数（BMI）、身体成分、骨密度（BMD）和卵巢功能的长期影响。
受试者/方法：92 名女性在成年后进行评估，分为以下三组：A 组，47 名特发性中枢性性早熟女孩（33 名 GnRHa 治疗，14 名未治疗）；B 组，24 名单纯生长激素缺乏症女孩（15 名 GnRHa 和 GH 治疗，9 名仅 GH 治疗）；C 组，21 名特发性身材矮小女孩（7 名 GnRHa 和 GH 治疗，7 名 GnRHa 治疗，7 名未治疗）。
三组 GnRHa 治疗患者的 FH、BMD 和脂肪质量百分比与各自的未治疗患者相当。A 组和 C 组 GnRHa 治疗和未治疗患者的 BMI 值相当，而 B 组仅接受 GH 治疗的患者 BMI 值更高。未接受治疗的特发性中枢性性早熟患者的最大卵巢体积更大，LH 和 LH/FSH 比值更高，多毛症更严重，而接受 GnRHa 治疗的患者则相反。治疗和未治疗的特发性中枢性性早熟患者的月经周期特征无差异。接受和未接受治疗的特发性中枢性性早熟女孩中多囊卵巢综合征的患病率相当，而在整个队列中，GnRHa 治疗组为 11.1%，未治疗组为 32.1%（P=0.02）。
儿童期接受 GnRHa 治疗的女孩在成年早期 BMI、BMD、身体成分和卵巢功能正常。在大约 8 岁开始接受 GnRHa 治疗的特发性中枢性性早熟女孩中，FH 并未增加。没有证据表明 GnRHa 治疗会导致多囊卵巢综合征或月经不规律。
