Park Jongho, Hwang Tae Ho, Kim Yong-Dae, Han Heon-Seok
Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Department of Pediatrics, National Medical Center, Seoul, Korea.
Ann Pediatr Endocrinol Metab. 2018 Mar;23(1):14-20. doi: 10.6065/apem.2018.23.1.14. Epub 2018 Mar 22.
Reported changes in body mass index (BMI) in central precocious puberty (CPP) during and after gonadotropin-releasing hormone analog (GnRHa) treatment are inconsistent. We, therefore, investigated auxological parameters in GnRHa-treated girls with idiopathic CPP (ICPP) until attainment of near final height (NFH).
From the medical records of 59 ICPP girls who attained NFH after GnRHa therapy, auxological changes were compared between overweight (BMI≥85th percentile) and normal-weight (BMI<85th percentile) groups. BMIs were changed into standard deviation scores (BMISDSs) for subject chronologic age (BMISDS-CA) and bone age (BMISDS-BA).
The incidence of overweight including obesity was high at the start of therapy (35.6%). The predicted adult height (PAH) at start of therapy was significantly shorter than the midparental height (MPH), whereas PAH at end of therapy approached MPH, and NFH was greater than MPH. Height velocity (HV) in the overweight group was higher during GnRHa therapy than that in the normal-weight group, but those in the two groups were not different after therapy until NFH. Both BMISDS-CA and BMISDS-BA increased significantly during therapy, but both BMISDSs decreased significantly after therapy until NFH. At NFH, neither BMISDS was different from that at baseline. In the normal-weight group, both BMISDSs increased during therapy and were maintained until NFH. In the overweight group, neither BMISDS changed during therapy, but there was a decrease after therapy until NFH.
The different patterns of BMISDS change during and after GnRHa therapy until NFH between the 2 groups were related to the different HV during GnRHa therapy.
关于促性腺激素释放激素类似物(GnRHa)治疗期间及之后中枢性性早熟(CPP)患者体重指数(BMI)的变化报道并不一致。因此,我们对接受GnRHa治疗的特发性中枢性性早熟(ICPP)女孩的生长学参数进行了研究,直至达到接近最终身高(NFH)。
从59例接受GnRHa治疗后达到NFH的ICPP女孩的病历中,比较超重(BMI≥第85百分位数)和正常体重(BMI<第85百分位数)组的生长学变化。将BMI转换为根据实际年龄(BMISDS-CA)和骨龄(BMISDS-BA)的标准差分数。
治疗开始时超重(包括肥胖)的发生率较高(35.6%)。治疗开始时的预测成人身高(PAH)显著低于父母平均身高(MPH),而治疗结束时PAH接近MPH,且NFH大于MPH。超重组在GnRHa治疗期间的身高速度(HV)高于正常体重组,但两组在治疗后直至NFH时并无差异。治疗期间BMISDS-CA和BMISDS-BA均显著增加,但治疗后直至NFH时两者均显著下降。在NFH时,两个BMISDS均与基线时无差异。在正常体重组中,两个BMISDS在治疗期间均增加并维持至NFH。在超重组中,治疗期间两个BMISDS均未改变,但治疗后直至NFH时有下降。
两组在GnRHa治疗期间及之后直至NFH时BMISDS变化的不同模式与GnRHa治疗期间不同的HV有关。