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血清促甲状腺激素和黄体生成素水平在 GnRH 激动剂治疗 12 个月后降低了中枢性性早熟女孩。

Serum Levels of Thyroid Stimulating Hormone and Luteinizing Hormone Are Decreased in Girls with Central Precocious Puberty after 12-Month GnRH Agonist Treatment.

机构信息

Department of Pediatrics, Korea University College of Medicine.

Department of Pediatrics, Myongji Hospital.

出版信息

Tohoku J Exp Med. 2020 Nov;252(3):193-197. doi: 10.1620/tjem.252.193.

Abstract

Puberty is the transitional period from childhood to adult that leads to growth spurt, sexual maturation and attainment of reproductive capacity. Precocious puberty is defined when secondary sexual characteristics develop before the age of eight for girls and nine for boys. Central precocious puberty (CPP) is diagnosed when the process is driven by premature activation of hypothalamic gonadotropin-releasing hormone (GnRH) secretion. Many factors promote CPP, and the thyroid function is thought to be one of them. In our previous study, thyroid stimulating hormone (TSH) was higher in the CPP group than that of the participants without CPP. This elevation of TSH in CPP is said to be associated with pubertal luteinizing hormone (LH) elevation. The aim of this study was to evaluate the causal relationship between TSH and LH in CPP patients. A total of 221 girls diagnosed with CPP and treated with GnRH agonists were included. All participants except one showed LH suppression (peak LH < 3 IU/L), and serum levels of follicle stimulating hormone (FSH) were also lower after the treatment. These results indicate that puberty has slowed down and that the patients were successfully treated for CPP. As for thyroid hormones, TSH was significantly lower and free thyroxine (fT4) levels were higher after 12 months of GnRH agonist treatment compared with baseline. With GnRH agonist treatment, the serum levels of LH and TSH were decreased, suggesting that the increase in serum TSH levels is associated with premature LH elevation in girls with CPP.

摘要

青春期是从儿童期到成年期的过渡阶段,导致生长突增、性成熟和获得生殖能力。性早熟是指女孩在 8 岁之前,男孩在 9 岁之前出现第二性征发育。中枢性性早熟(CPP)是指下丘脑促性腺激素释放激素(GnRH)分泌过早激活导致的性早熟。许多因素可促进 CPP,甲状腺功能被认为是其中之一。在我们之前的研究中,CPP 组的促甲状腺激素(TSH)高于无 CPP 组的参与者。CPP 中 TSH 的这种升高与青春期黄体生成素(LH)的升高有关。本研究旨在评估 TSH 和 LH 之间在 CPP 患者中的因果关系。共纳入 221 名被诊断为 CPP 并接受 GnRH 激动剂治疗的女孩。除 1 名患者外,所有患者均显示 LH 抑制(峰值 LH<3IU/L),且治疗后血清卵泡刺激素(FSH)水平也较低。这些结果表明青春期已经减缓,患者的 CPP 得到成功治疗。至于甲状腺激素,与基线相比,GnRH 激动剂治疗 12 个月后 TSH 显著降低,游离甲状腺素(fT4)水平升高。随着 GnRH 激动剂的治疗,血清 LH 和 TSH 水平下降,提示 CPP 女孩中血清 TSH 水平的升高与 LH 过早升高有关。

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