Jung Mo Kyung, Song Kyung Chul, Kwon Ah Reum, Chae Hyun Wook, Kim Duk Hee, Kim Ho-Seong
Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Sowha Children's Hospital, Seoul, Korea.
Ann Pediatr Endocrinol Metab. 2014 Dec;19(4):214-9. doi: 10.6065/apem.2014.19.4.214. Epub 2014 Dec 31.
There is controversy surrounding the growth outcomes of treatment with gonadotropin-releasing hormone agonist (GnRHa) in central precocious puberty (CPP). We analyzed height preservation after treatment with GnRHa with and without growth hormone (GH) in girls with CPP.
We reviewed the medical records of 82 girls with idiopathic CPP who had been treated with GnRHa at Severance Children's Hospital from 2004 to 2014. We assessed the changes in height standard deviation score (SDS) for bone age (BA), and compared adult height (AH) with midparental height (MPH) and predicted adult height (PAH) during treatment in groups received GnRHa alone (n=59) or GnRHa plus GH (n=23).
In the GnRHa alone group, the height SDS for BA was increased during treatment. AH (160.4±4.23 cm) was significantly higher than the initial PAH (156.6±3.96 cm) (P<0.001), and it was similar to the MPH (159.9±3.52 cm). In the GnRHa plus GH group, the height SDS for BA was also increased during treatment. AH (159.3±5.33 cm) was also higher than the initial PAH (154.6±2.55 cm) (P<0.001), which was similar to the MPH (158.1±3.31 cm). Height gain was slightly higher than that in the GnRHa alone group, however it statistically showed no significant correlation with GH treatment.
In CPP girls treated with GnRHa, the height SDS for BA was increased, and the AH was higher than the initial PAH. Combined GH treatment showed a limited increase in height gain.
关于促性腺激素释放激素激动剂(GnRHa)治疗中枢性性早熟(CPP)后的生长结局存在争议。我们分析了CPP女童在使用GnRHa治疗时联合或不联合生长激素(GH)后的身高维持情况。
我们回顾了2004年至2014年在Severance儿童医院接受GnRHa治疗的82例特发性CPP女童的病历。我们评估了骨龄(BA)的身高标准差评分(SDS)变化,并比较了单独接受GnRHa治疗组(n = 59)或GnRHa联合GH治疗组(n = 23)在治疗期间的成人身高(AH)与父母平均身高(MPH)及预测成人身高(PAH)。
在单独使用GnRHa组中,治疗期间BA的身高SDS增加。AH(160.4±4.23 cm)显著高于初始PAH(156.6±3.96 cm)(P<0.001),且与MPH(159.9±3.52 cm)相似。在GnRHa联合GH组中,治疗期间BA的身高SDS也增加。AH(159.3±5.33 cm)也高于初始PAH(154.6±2.55 cm)(P<0.001),与MPH(158.1±3.31 cm)相似。身高增长略高于单独使用GnRHa组,但统计学上显示与GH治疗无显著相关性。
在接受GnRHa治疗的CPP女童中,BA的身高SDS增加,且AH高于初始PAH。联合GH治疗显示身高增长增加有限。