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一种新型数学模型在预测特发性中枢性性早熟女童成年身高和初潮年龄方面的适用性。

Applicability of a novel mathematical model for the prediction of adult height and age at menarche in girls with idiopathic central precocious puberty.

作者信息

Lopes Mateus Cavarzan, Ramos Carolina Oliveira, Latronico Ana Claudia, Mendonça Berenice B, Brito Vinicius N

机构信息

Iniciacao Cientifica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Unidade de Endocrinologia do Desenvolvimento e Laboratorio de Hormonios e Genetica Molecular LIM/42, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.

出版信息

Clinics (Sao Paulo). 2018 Jul 26;73:e480. doi: 10.6061/clinics/2018/e480.

Abstract

OBJECTIVES

Unfavorable predicted adult height and psychosocial inadequacy represent parameters used to guide therapeutic intervention in girls with central precocious puberty. Gonadotropin-releasing hormone analog is the first-line treatment. The aim of this study was to compare two methods used to predict adult height and assess a validated tool for predicting the age at menarche in girls with central precocious puberty.

METHODS

The predicted adult height of 48 girls with central precocious puberty was calculated at diagnosis using the Bayley-Pinneau method based on average and advanced bone age tables and compared with the predicted adult height calculated using a mathematical model. In addition, the age at spontaneous menarche was predicted using the new formulae. After Gonadotropin-releasing hormone analog treatment, the predicted adult height was calculated using only the Bayley-Pinneau tables.

RESULTS

The achieved adult height was within the target height range in all treated girls with central precocious puberty. At diagnosis, the predicted adult height using the Bayley-Pinneau tables was lower than that using the mathematical model. After the Gonadotropin-releasing hormone analog treatment, the predicted adult height using the Bayley-Pinneau method with the average bone age tables was the closest to the achieved adult height. Using the formulae, the predicted age at spontaneous menarche was 10.1±0.5 yr. The Gonadotropin-releasing hormone analog treatment significantly postponed this event until 11.9±0.7 yr in these "idiopathic" central precocious puberty girls, highlighting the beneficial effect of this treatment.

CONCLUSION

Both initial adult height prediction methods are limited and must be used with caution. The prediction of the age at spontaneous menarche represents an innovative tool that can help in clinical decisions regarding pubertal suppression.

摘要

目的

预测的成年身高不理想和心理社会适应不良是用于指导中枢性性早熟女孩治疗干预的参数。促性腺激素释放激素类似物是一线治疗方法。本研究的目的是比较两种用于预测成年身高的方法,并评估一种经过验证的预测中枢性性早熟女孩初潮年龄的工具。

方法

对48例中枢性性早熟女孩在诊断时使用基于平均骨龄表和进阶骨龄表的贝利 - 平诺方法计算预测成年身高,并与使用数学模型计算的预测成年身高进行比较。此外,使用新公式预测自然初潮年龄。在促性腺激素释放激素类似物治疗后,仅使用贝利 - 平诺骨龄表计算预测成年身高。

结果

所有接受治疗的中枢性性早熟女孩的成年身高均在目标身高范围内。诊断时,使用贝利 - 平诺骨龄表预测的成年身高低于使用数学模型预测的成年身高。在促性腺激素释放激素类似物治疗后,使用平均骨龄表的贝利 - 平诺方法预测的成年身高最接近实际成年身高。使用这些公式,预测的自然初潮年龄为10.1±0.5岁。在这些“特发性”中枢性性早熟女孩中,促性腺激素释放激素类似物治疗显著将初潮推迟至11.9±0.7岁,突出了该治疗的有益效果。

结论

两种初始成年身高预测方法都有局限性,必须谨慎使用。自然初潮年龄的预测是一种创新工具,有助于在青春期抑制的临床决策中提供帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/880e/6055021/f83b323d6b21/cln-73-480-g001.jpg

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