Muratoglu Sahin Nursel, Peltek Kendirci Havva Nur, Çetinkaya Semra, Savaş Erdeve Şenay, Aycan Zehra
Dr. Sami Ulus Obstetrics and Gynaecology, Paediatric Health and Disease Training and Research Hospital, Paediatric Endocrinology Clinic, Ankara, Turkey.
Hitit University, Division of Paediatric Endocrinology, Corum, Turkey.
J Pediatr Endocrinol Metab. 2020 Jan 28;33(1):113-120. doi: 10.1515/jpem-2018-0482.
Background Some studies have examined the effect of gonadal suppression on insulin-like growth factor-1 (IGF-1) levels and the growth velocity (GV) with conflicting results. Methods Forty-four girls treated with gonadotropin-releasing hormone analogue (GnRHa) for central precocious puberty (CPP) were included in the study. IGF-1 levels were examined at the beginning and after 12 months of treatment. Results IGF-1 and IGF-1 standard deviation score (SDS) according to chronological age (CA-IGF-1 SDS) at diagnosis were positively correlated with chronological age (CA), anthropometric measurements, stage of puberty, bone age (BA), BA-CA, follicle-stimulating hormone (FSH), luteinising hormone (LH), oestradiol, uterus length, endometrium thickness and ovarian volume (OV) at diagnosis (p < 0.05). There was no significant difference in IGF-1 levels after treatment. However, there was a negative correlation between ΔIGF-1 SDS and IGF-1 level, CA-IGF-1 SDS and BA-IGF-1 SDS at diagnosis (p < 0.05). There was no correlation between GV and IGF-1, ΔIGF-1. GV was negatively correlated with basal LH level at diagnosis (p = 0.008, r = -0.397). Peak LH levels of the patients who had GV-SDS < 0 were more suppressive than those of the patients who had GV-SDS > 0 after 12 months of treatment. Conclusions It was determined that the IGF-1 level and CA-IGF-1 SDS at baseline were correlated with more advanced pubertal stage prior to treatment. Initiation of treatment with a relatively high level of IGF-1 increased the risk of a decrease in the IGF-1 level. Likewise, the initiation of treatment with a relatively high LH level may increase the risk of low GV, but low GV was not related to the IGF-1 level. Increased sex steroid suppression may increase the risk of low GV.
一些研究探讨了性腺抑制对胰岛素样生长因子-1（IGF-1）水平和生长速度（GV）的影响，结果相互矛盾。
本研究纳入了44例接受促性腺激素释放激素类似物（GnRHa）治疗中枢性性早熟（CPP）的女孩。在治疗开始时和治疗12个月后检测IGF-1水平。
诊断时的IGF-1水平及按实足年龄计算的IGF-1标准差分值（CA-IGF-1 SDS）与实足年龄（CA）、人体测量指标、青春期分期、骨龄（BA）、BA-CA、促卵泡生成素（FSH）、促黄体生成素（LH）、雌二醇、子宫长度、子宫内膜厚度及卵巢体积（OV）呈正相关（p<0.05）。治疗后IGF-1水平无显著差异。然而，诊断时ΔIGF-1 SDS与IGF-1水平、CA-IGF-1 SDS与BA-IGF-1 SDS呈负相关（p<0.05）。GV与IGF-1、ΔIGF-1无相关性。GV与诊断时的基础LH水平呈负相关（p = 0.008，r = -0.397）。治疗12个月后，GV-SDS<0的患者的LH峰值水平比GV-SDS>0的患者受抑制更明显。
确定基线时的IGF-1水平和CA-IGF-1 SDS与治疗前更 advanced 的青春期阶段相关。以相对较高的IGF-1水平开始治疗会增加IGF-1水平降低的风险。同样，以相对较高的LH水平开始治疗可能会增加低GV的风险，但低GV与IGF-1水平无关。性类固醇抑制增加可能会增加低GV的风险。
