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特发性中枢性性早熟女童应用促性腺激素释放激素类似物治疗后的成年身高、体重指数和初潮时间。

Adult height, body mass index and time of menarche of girls with idiopathic central precocious puberty after gonadotropin-releasing hormone analogue treatment.

机构信息

Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.

出版信息

Gynecol Endocrinol. 2011 Aug;27(8):524-8. doi: 10.3109/09513590.2010.507289. Epub 2011 Apr 18.

Abstract

BACKGROUND

Long-term outcome data of central precocious puberty (CPP) girls treated with gonadotropin-releasing hormone analogue (GnRHa) are conflicting.

AIM

To assess long-term outcome of girls with idiopathic CPP (iCPP) treated with GnRHa.

METHODS

We compared adult height (AH), body mass index (BMI) and time of menarche in GnRHa-treated (n = 47) and untreated (n = 11) girls with iCPP.

RESULTS

There were no differences in age, bone age, height, weight and BMI z-scores, predicted adult height (PAH) at the time of diagnosis and target height between the two groups. Mean (SD) age of GnRHa-treated girls was 8.5 (1.0) years at the start of treatment. Mean (SD) AH of the treated group was greater [158.6 (5.2) vs. 154.8 (5.6) cm], p < 0.05. AH gain over pre-treatment PAH in the treated group was 4.7 cm. BMI z-score of treated girls was 1.26 (0.95) before the treatment initiated and returned to normal [0.16 (1.0)] at the time of AH reached. Menstruation occurred at 0.9 (0.5) years following GnRHa discontinuation with regular pattern.

CONCLUSIONS

Long-term GnRHa therapy has a modest beneficial effect on adult height gain in girls with iCPP. No detrimental effects on increasing BMI and hypothalamic-pituitary-gonadal axis reactivation are demonstrated.

摘要

背景

促性腺激素释放激素类似物(GnRHa)治疗中枢性性早熟(CPP)女孩的长期结局数据存在争议。

目的

评估接受 GnRHa 治疗的特发性 CPP(iCPP)女孩的长期结局。

方法

我们比较了接受 GnRHa 治疗(n=47)和未治疗(n=11)的 iCPP 女孩的成年身高(AH)、体重指数(BMI)和初潮时间。

结果

两组间在年龄、骨龄、身高、体重和 BMI z 评分、初诊时的预测成年身高(PAH)和靶身高无差异。GnRHa 治疗组女孩开始治疗时的平均(SD)年龄为 8.5(1.0)岁。治疗组的平均(SD)AH 更高[158.6(5.2)cm 比 154.8(5.6)cm],p<0.05。治疗组的 AH 增长超过治疗前的 PAH 为 4.7cm。治疗前女孩的 BMI z 评分是 1.26(0.95),治疗后恢复正常[0.16(1.0)]。GnRHa 停药后月经初潮时间为 0.9(0.5)年,且呈规律模式。

结论

长期 GnRHa 治疗对 iCPP 女孩的成年身高增长有适度的有益影响。没有证据表明增加 BMI 和下丘脑-垂体-性腺轴重新激活有不良影响。

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