Censani Marisa, Feuer Alexis, Orton Sarah, Askin Gulce, Vogiatzi Maria
Weill Cornell Medicine, New York Presbyterian Hospital, Division of Pediatric Endocrinology, Department of Pediatrics, New York, NY, USA.
Weill Cornell Medicine, Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, New York, NY, USA.
J Pediatr Endocrinol Metab. 2019 Oct 25;32(10):1065-1070. doi: 10.1515/jpem-2019-0105.
Background The use of gonadotropin-releasing hormone agonists (GnRHa) for pubertal suppression has been associated with increased body mass index (BMI) in female subjects with central precocious puberty (CPP), although results have been so far conflicting. This study examined the effects of GnRHa therapy in both genders and in subjects treated for CPP, early puberty or short stature. Methods This was a longitudinal retrospective study of subjects followed at outpatient pediatric endocrinology clinics of an academic medical center from 2005 to 2014 receiving GnRHa therapy. Results At 12 months, subjects on depot GnRHa had a statistically significant increase in BMI standard deviation score (SDS) from baseline (0.13 ± 0.35, p < 0.02). Subjects with short stature (0.17 ± 0.34, p < 0.02) but not early or precocious puberty, and subjects with normal baseline BMI (0.18 ± 0.38, p < 0.02) had significant increases in BMI SDS; no significance was noted at 24 months. Male subjects did not have a significant increase in BMI SDS, whereas female subjects did (0.11 ± 0.36, p < 0.01). Conclusions Subjects with short stature, normal BMI at baseline and female sex had significant increases in BMI SDS at 12 months. This is the first study to show an increase in BMI SDS in children treated with GnRHa for short stature, and is one of the few studies to assess BMI changes in males.
促性腺激素释放激素激动剂（GnRHa）用于青春期抑制与中枢性性早熟（CPP）女性受试者体重指数（BMI）增加有关，尽管迄今为止结果存在矛盾。本研究调查了GnRHa治疗对两性以及治疗CPP、青春期提前或身材矮小的受试者的影响。方法：这是一项对2005年至2014年在一所学术医学中心门诊儿科内分泌诊所接受GnRHa治疗的受试者进行的纵向回顾性研究。结果：在12个月时，接受长效GnRHa治疗的受试者BMI标准差评分（SDS）较基线有统计学显著增加（0.13±0.35，p<0.02）。身材矮小的受试者（0.17±0.34，p<0.02）而非青春期提前或性早熟的受试者，以及基线BMI正常的受试者（0.18±0.38，p<0.02）的BMI SDS有显著增加；在24个月时未观察到显著差异。男性受试者的BMI SDS没有显著增加，而女性受试者有（0.11±0.36，p<0.01）。结论：身材矮小、基线BMI正常的受试者以及女性在12个月时BMI SDS有显著增加。这是第一项显示接受GnRHa治疗的身材矮小儿童BMI SDS增加的研究，也是少数评估男性BMI变化的研究之一。
