Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
Gynecol Endocrinol. 2011 Aug;27(8):524-8. doi: 10.3109/09513590.2010.507289. Epub 2011 Apr 18.
Long-term outcome data of central precocious puberty (CPP) girls treated with gonadotropin-releasing hormone analogue (GnRHa) are conflicting.
To assess long-term outcome of girls with idiopathic CPP (iCPP) treated with GnRHa.
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.
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.
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.
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。
评估接受 GnRHa 治疗的特发性 CPP(iCPP)女孩的长期结局。
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。
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。
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。