Demirkale Zeynep Hizli, Abali Zehra Yavas, Bas Firdevs, Poyrazoglu Sukran, Bundak Ruveyde, Darendeliler Feyza
Istanbul Faculty of Medicine, Department of Pediatrics, Istanbul University, Istanbul, Turkey.
Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
J Pediatr Adolesc Gynecol. 2019 Jun;32(3):264-270. doi: 10.1016/j.jpag.2019.01.003. Epub 2019 Jan 10.
Risks associated with precocious puberty might be observed in the rapidly progressive form of borderline early puberty (BEP). Differentiating the rate of progression is important for deciding treatment with gonadotropin-releasing hormone analogue (GnRHa). The aim was to examine the treatment characteristics and effect of treatment on predicted adult height (PAH).
Retrospective observational study.
Single-center, a pediatric endocrinology unit.
A total of 135 girls, pubertal findings starting between 7-10 years of age.
Data were collected via chart review. Patient groups were defined as treated with GnRHa (n = 63) or untreated (n = 72) girls.
Referral characteristics and anthropometric and pubertal findings of the patients with BEP, effect of treatment on PAH, and final height of the groups were compared.
The mean (±SD) age of the patients at admission and for the first appearence of pubertal findings was 8.8 ± 1.0 and 8.0 ± 0.8 years, respectively. Target height and PAH-target height values at admission were similar. At initiation of treatment, PAH of the treated girls (157.8 ± 7.2 cm) were significantly lower compared with untreated girls (160.7 ± 6.5 cm). The age at menarche of patients in the treated and untreated groups were 12.3 ± 1.0 and 11.3 ± 1.1 years, respectively. The final height of the groups were similar (157.1 ± 6.6 vs 157.0 ± 5.9 cm; P = .922) despite a lower PAH of the treated group.
GnRHa treatment resulted in an increase in PAH and normalized the age of menarche in patients with BEP. In selected girls with rapidly progressive BEP, GnRHa treatment may be considered.
在快速进展型的边缘性性早熟（BEP）中可能观察到与性早熟相关的风险。区分进展速度对于决定使用促性腺激素释放激素类似物（GnRHa）进行治疗很重要。目的是研究治疗特征以及治疗对预测成年身高（PAH）的影响。
回顾性观察研究。
单中心，儿科内分泌科。
共135名女孩，青春期体征始于7至10岁之间。
通过病历审查收集数据。患者组被定义为接受GnRHa治疗的女孩（n = 63）和未接受治疗的女孩（n = 72）。
比较BEP患者的转诊特征、人体测量和青春期体征、治疗对PAH的影响以及两组的最终身高。
患者入院时及青春期体征首次出现时的平均（±标准差）年龄分别为8.8±1.0岁和8.0±0.8岁。入院时的靶身高和PAH - 靶身高值相似。开始治疗时，接受治疗的女孩的PAH（157.8±7.2厘米）显著低于未接受治疗的女孩（160.7±6.5厘米）。治疗组和未治疗组患者的初潮年龄分别为12.3±1.0岁和11.3±1.1岁。尽管治疗组的PAH较低，但两组的最终身高相似（157.1±6.6 vs 157.0±5.9厘米；P = 0.922）。
GnRHa治疗可使BEP患者的PAH增加，并使初潮年龄正常化。对于部分快速进展型BEP女孩，可考虑GnRHa治疗。
