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促性腺激素释放激素类似物以及促性腺激素释放激素类似物与重组人生长激素联合使用对性早熟女童成年身高的影响

The Effects of Gonadotropin-Releasing Hormone Analog and a Combination of Gonadotropin-Releasing Hormone Analog and Recombinant Human Growth Hormone on Adult Height in Girls with Early Puberty.

作者信息

Hajzadeh Ghodsieh, Ghaemi Norsrat, Hadjzadeh Mousa-Al-Reza, Noroozi Samaneh, Morovatdar Negar

机构信息

Department of Pediatric Endocrinology and Metabolism, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Adv Biomed Res. 2019 Sep 23;8:57. doi: 10.4103/abr.abr_121_19. eCollection 2019.

Abstract

BACKGROUND

Early puberty (EP) is due to the activation of gonadotropin-releasing hormone (GnRH) pulse generator in lower ages; EP may be a potential cause for impairment of adult height, leading to short stature. The aim of this study was to determine the effects of GnRH analog (GnRHa) and GnRHa plus recombinant human growth hormone (rhGH) treatment on final height in healthy girls with EP.

MATERIALS AND METHODS

Fifty EP girls (sexual maturity rating: 2-3) with chronological age (CA) 9.22 ± 0.56 and bone age (BA) 9.74 ± 0.59 years were treated with GnRHa (Triptorelin) at a dose of 100 μg/kg body weight (BW) as intramuscular every 28 days for 2.82 ± 0.57 years; 45 EP girls with CA 9.84 ± 0.57 and BA 10.14 ± 1.02 years were also treated with the same GnRHa plus rhGH (Norditropin) at a dose of 0.1 unit/kg BW daily for 6 days in a week for 2.55 ± 0.6 years. In the control group, 33 EP girls followed for the same period without treatment. Height, weight, and body mass index of girls and parents were assessed. Predicted adult height (PAH) at the start and the end of the study and target height were assessed.

RESULTS

PAH at the end of the study in the GnRHa group was not different with untreated girls. PAH at the end of the treatment in GnRHa plus rhGH group was significantly higher than both untreated and GnRHa group. PAH at the end of therapy in GnRHa plus rhGH group was significantly more than their target height.

CONCLUSION

GnRHa therapy has a benefit effect in achievement of target height. Combination therapy with GnRHa plus rhGH increased their PAH more than both untreated and GnRHa groups.

摘要

背景

性早熟(EP)是由于促性腺激素释放激素(GnRH)脉冲发生器在较低年龄被激活;性早熟可能是影响成人身高、导致身材矮小的一个潜在原因。本研究的目的是确定GnRH类似物(GnRHa)以及GnRHa联合重组人生长激素(rhGH)治疗对健康性早熟女童最终身高的影响。

材料与方法

50名性早熟女童(性成熟评级:2 - 3级),其实际年龄(CA)为9.22±0.56岁,骨龄(BA)为9.74±0.59岁,接受GnRHa(曲普瑞林)治疗,剂量为100μg/kg体重(BW),每28天肌肉注射一次,持续2.82±0.57年;45名实际年龄为9.84±0.57岁、骨龄为10.14±1.02岁的性早熟女童,同样接受GnRHa治疗,同时加用rhGH(诺和诺德生长激素),剂量为0.1单位/kg体重,每周6天,持续2.55±0.6年。对照组为33名性早熟女童,随访同期未接受治疗。评估女童及其父母的身高、体重和体重指数。评估研究开始和结束时的预测成人身高(PAH)以及靶身高。

结果

GnRHa组研究结束时的PAH与未治疗女童无差异。GnRHa加rhGH组治疗结束时的PAH显著高于未治疗组和GnRHa组。GnRHa加rhGH组治疗结束时的PAH显著高于其靶身高。

结论

GnRHa治疗对实现靶身高有有益作用。GnRHa联合rhGH治疗组的PAH升高幅度大于未治疗组和GnRHa组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/668f/6777143/d79ff157b207/ABR-8-57-g001.jpg

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