Hamza Rasha Tarif, Deeb Asma, Al Saffar Hussain, Alani Sarah Hussein, Habeb Abdelhadi
Department of Pediatric Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Pediatric Endocrinology, Shaikh Shakhbout Medical City, Abu Dhabi, UAE.
J Pediatr Endocrinol Metab. 2020 Sep 25;33(9):1197-1202. doi: 10.1515/jpem-2020-0157.
Objectives There are some variations in the practice of puberty induction between different regions; however, data from Arab countries are lacking. We aimed to survey the practice of pediatric endocrinologists in Arab countries on the timing and regimen for puberty induction in girls and boys with hypogonadism. Methods An online questionnaire was emailed to physicians registered in the Arab Society for Paediatric Endocrinology and Diabetes. Results In total, 106 replies from 17 countries were received. In non Turner syndrome (TS) girls, puberty was induced by 49.4% of participants at 12-13 years and by 32.5% at ≥14 years. Ethinyl estradiol and conjugated estrogen were the most popular preparations used (29.7 and 16.6%, respectively). Of the participants, 60% introduce progesterone either at 2-3 years after starting estrogen or following a significant breakthrough bleeding on estrogen. In girls with TS, 84.2% of participants prescribed estrogen to those aged 11 years and older (51.5% at 11-12 years) and 5.3% prescribed it to those at the prepubertal age. In boys, 57.3% of participants induce at ≥14 years, 80.6% use intramuscular testosterone and 46.5% start with 50 mg/kg/month. Human chorionic gonadotropin is more used in non-Gulf Arab countries (18.2 vs. 2.9%; p 0.036) with a trend of using oral testosterone undecanoate in Gulf states (12.2 vs. 2.0%; p 0.051). Conclusions We describe the approach to puberty induction in boys and girls among pediatric endocrinologists in Arab countries. The observed variation in practice would be useful in developing regional consensus guidelines on puberty induction in children with hypogonadism.
目的 不同地区在青春期诱导的实践方面存在一些差异；然而，来自阿拉伯国家的数据却很缺乏。我们旨在调查阿拉伯国家儿科内分泌学家对性腺功能减退的女孩和男孩进行青春期诱导的时机和方案。方法 向在阿拉伯儿科内分泌学与糖尿病学会注册的医生发送了一份在线问卷。结果 共收到来自17个国家的106份回复。在非特纳综合征（TS）女孩中，49.4%的参与者在12至13岁时诱导青春期，32.5%的参与者在≥14岁时诱导。乙炔雌二醇和结合雌激素是最常用的制剂（分别为29.7%和16.6%）。在参与者中，60%在开始使用雌激素后2至3年或在雌激素出现大量突破性出血后引入孕激素。在患有TS的女孩中，84.2%的参与者给11岁及以上的女孩开雌激素（11至12岁的女孩中为51.5%），5.3%的参与者给青春期前的女孩开雌激素。在男孩中，57.3%的参与者在≥14岁时诱导青春期，80.6%使用肌内注射睾酮，46.5%从50mg/kg/月开始。人绒毛膜促性腺激素在非海湾阿拉伯国家使用得更多（18.2%对2.9%；p = 0.036），海湾国家有使用十一酸睾酮口服制剂的趋势（12.2%对2.0%；p = 0.051）。结论 我们描述了阿拉伯国家儿科内分泌学家对男孩和女孩进行青春期诱导的方法。观察到的实践差异将有助于制定关于性腺功能减退儿童青春期诱导的区域共识指南。
