Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Department of Urology, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.
Clin Endocrinol (Oxf). 2020 Aug;93(2):135-145. doi: 10.1111/cen.14214. Epub 2020 Jun 3.
This analysis of previously published reports was performed to examine the effects of gonadotropin-releasing hormone (GnRH) agonist treatment on adult height and the factors associated with adult height outcomes.
GnRH agonists are first-line agents in the treatment of precocious puberty. However, studies regarding the treatment effect on subjects with early puberty have reported inconsistent results.
A total of 14 studies identified from a search of electronic databases (AMED, EMBASE, MEDLINE and RISS) were included. Controlled studies with girls who developed puberty before 10 years of age and measurements of the adult heights of the subjects were selected. Studies using only long-acting GnRH agonists to suppress puberty were included. Adult height, duration of the treatment, age at the start of treatment and bone age advancement were analysed.
The mean age of the subjects ranged from 6.3 to 9.0 years. The meta-analysis showed a pooled mean difference in adult height of 3.2 cm and a 95% confidence interval of 1.3-5.1 cm. The height difference between the treated subjects and controls was significantly associated with the duration of treatment (P = .005) rather than the age at the start of treatment (P = .084) or the difference between bone age and chronological age (P = .427).
Administration of GnRH agonists in girls who develop early puberty and demonstrate advanced bone age may be effective for increasing adult height, especially if a sufficiently long treatment duration can be achieved.
分析已发表的报告，以研究促性腺激素释放激素（GnRH）激动剂治疗对成年身高的影响，以及与成年身高结果相关的因素。
GnRH 激动剂是治疗性早熟的一线药物。然而，关于对青春期提前的患者进行治疗效果的研究结果不一致。
通过对电子数据库（AMED、EMBASE、MEDLINE 和 RISS）进行检索，共纳入 14 项研究。选择了对 10 岁前出现青春期的女孩进行治疗，并对受试者的成年身高进行测量的对照研究。仅纳入使用长效 GnRH 激动剂抑制青春期的研究。分析成年身高、治疗持续时间、治疗开始时的年龄和骨龄进展。
受试者的平均年龄为 6.3-9.0 岁。荟萃分析显示，成年身高的平均差异为 3.2cm，95%置信区间为 1.3-5.1cm。治疗组与对照组的身高差异与治疗持续时间显著相关（P=.005），而与治疗开始时的年龄（P=.084）或骨龄与实际年龄的差异（P=.427）无关。
对于出现早期青春期和骨龄提前的女孩，使用 GnRH 激动剂治疗可能有效增加成年身高，尤其是如果能达到足够长的治疗持续时间。
