Tinggaard Jeanette, Jensen Rikke Beck, Sundberg Karin, Birkebæk Niels, Christiansen Peter, Ellermann Annie, Holm Kirsten, Jeppesen Eva Mosfeldt, Kremke Britta, Marcinski Pawel, Pedersen Carsten, Saurbrey Nina, Thisted Ebbe, Main Katharina M, Juul Anders
Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Fertil Steril. 2014 Dec;102(6):1733-41. doi: 10.1016/j.fertnstert.2014.09.014. Epub 2014 Oct 18.
To study the effect of growth hormone (GH) treatment on ovarian and uterine morphology and function in short, prepubertal small-for-gestational-age (SGA) girls.
A multinational, randomized controlled trial on safety and efficacy of GH therapy in short, prepubertal children born SGA.
Not applicable.
PATIENT(S): A subgroup of 18 Danish girls born SGA included in North European SGA Study (NESGAS).
INTERVENTION(S): One year of GH treatment (67 μg/kg/day) followed by 2 years of randomized GH treatment (67 μg/kg/day, 35 μg/kg/day, or IGF-I titrated).
MAIN OUTCOME MEASURE(S): Data on anthropometrics, reproductive hormones, and ultrasonographic examination of the internal genitalia were collected during 36 months of GH treatment.
RESULT(S): Uterine and ovarian volume increased significantly during 3 years of treatment (64% and 110%, respectively) but remained low within normal reference ranges. Ovarian follicles became visible in 58% after 1 year compared with 28% before GH therapy. Anti-Müllerian hormone increased significantly during the 3 years of GH therapy but remained within the normal range. Precocious puberty was observed in one girl; another girl developed multicystic ovaries.
CONCLUSION(S): GH treatment was associated with statistically significant growth of the internal genitalia, but remained within the normal range. As altered pubertal development and ovarian morphology were found in 2 of 18 girls, monitoring of puberty and ovarian function during GH therapy in SGA girls is prudent. Altogether, the findings are reassuring. However, long-term effects of GH treatment on adult reproductive function remain unknown.
EudraCT 2005-001507-19.
研究生长激素（GH）治疗对青春期前身材矮小的小于胎龄儿（SGA）女童卵巢及子宫形态和功能的影响。
一项关于GH治疗对青春期前身材矮小的SGA出生儿童安全性和有效性的多国随机对照试验。
不适用。
纳入北欧小于胎龄儿研究（NESGAS）的18名丹麦SGA出生女童亚组。
1年GH治疗（67μg/kg/天），随后2年随机GH治疗（67μg/kg/天、35μg/kg/天或IGF-I滴定）。
在36个月的GH治疗期间收集人体测量学、生殖激素及内生殖器超声检查数据。
治疗3年期间子宫和卵巢体积显著增加（分别增加64%和110%），但仍低于正常参考范围。GH治疗1年后58%的女童可见卵巢卵泡，而治疗前为28%。抗苗勒管激素在3年GH治疗期间显著增加，但仍在正常范围内。观察到1名女童性早熟；另1名女童出现多囊卵巢。
GH治疗与内生殖器的统计学显著生长相关，但仍在正常范围内。由于18名女童中有2名出现青春期发育改变和卵巢形态改变，因此对SGA女童进行GH治疗期间监测青春期和卵巢功能是审慎的。总体而言，这些发现令人安心。然而，GH治疗对成年生殖功能的长期影响仍未知。
EudraCT 2005-001507-19。
