Division of EndocrinologyDiabetes, and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti, 14, I-10126 Turin, ItalyDepartment of Biomedical and Neuromotor SciencesSchool of Hygiene and Preventive Medicine, DIBINEM, University of Bologna, Bologna, Italy.
Eur J Endocrinol. 2016 Mar;174(3):R79-87. doi: 10.1530/EJE-15-0590. Epub 2015 Oct 14.
GnRH analogues (GnRHa) are the treatment of choice for central precocious puberty (CPP), with the main objective to recover the height potential compromised by the premature fusion of growth cartilages. The aim of this review was to analyze long-term effects of GnRHa on height, body weight, reproductive function, and bone mineral density (BMD) in patients with CPP, as well as the potential predictors of outcome. Because randomized controlled trials on the effectiveness and long-term outcomes of treatment are not available, only qualified conclusions about the efficacy of interventions can be drawn. GnRHa treatment appears to improve adult height in girls with CPP, especially if diagnosed before the age of 6, whereas a real benefit in terms of adult height is still controversial in patients with the onset of puberty between 6 and 8 years of age. No height benefit was shown in patients treated after 8 years. Gonadal function is promptly restored in girls after cessation of treatment, and reproductive potential appears normal in young adulthood. Data are conflicting on the long-term risk of polycystic ovarian syndrome in both treated and untreated women. Fat mass is increased at the start of treatment but normalizes thereafter, and GnRHa itself does not seem to have any long-term effect on BMI. Similarly, analogue treatment does not appear to have a negative impact on BMD. Owing to the paucity of data available, no conclusions can be drawn on the repercussions of CPP and/or its treatment on the timing of menopause and on the health of the offspring.
促性腺激素释放激素类似物（GnRHa）是治疗中枢性性早熟（CPP）的首选方法，主要目的是恢复因生长软骨过早融合而受损的身高潜力。本综述旨在分析 GnRHa 对 CPP 患者身高、体重、生殖功能和骨密度（BMD）的长期影响，以及预测结局的潜在因素。由于目前尚无关于治疗有效性和长期结局的随机对照试验，因此只能对干预措施的疗效得出有条件的结论。GnRHa 治疗似乎可改善 CPP 女孩的成年身高，尤其是在 6 岁之前诊断的患者，而对于青春期开始于 6-8 岁的患者，成年身高的真正获益仍存在争议。对于 8 岁以后开始治疗的患者，身高获益不明显。治疗停止后，女孩的性腺功能迅速恢复，生育能力在成年早期似乎正常。关于治疗和未治疗女性长期多囊卵巢综合征风险的数据存在争议。脂肪量在开始治疗时增加，但随后恢复正常，GnRHa 本身似乎对 BMI 没有长期影响。同样，类似物治疗似乎对 BMD 也没有负面影响。由于数据有限，对于 CPP 及其治疗对绝经时间和后代健康的影响，无法得出结论。
