促性腺激素释放激素激动剂治疗中枢性性早熟男孩的长期结局。
Long-term outcomes after gonadotropin-releasing hormone agonist treatment in boys with central precocious puberty.
机构信息
Department of Pediatrics, Hallym University Medical Center, School of Medicine, Hallym University, Seoul, South Korea.
Department of Pediatrics, Gachon University School of Medicine, Gil Medical Center, Seoul, South Korea.
出版信息
PLoS One. 2020 Dec 10;15(12):e0243212. doi: 10.1371/journal.pone.0243212. eCollection 2020.
OBJECTIVE
Gonadotropin-releasing hormone agonist (GnRHa) treatment improves the potential for gaining height in patients with central precocious puberty (CPP). However, most studies have focused on girls because CPP in boys is relatively rare. Therefore, we aimed to determine the effect of GnRHa treatment on auxological outcomes in boys with CPP.
METHODS
Eighty-five boys with CPP were treated with leuprolide or triptorelin acetate 3.75 mg over 2 years. Anthropometry, bone age, sexual maturity rating, and predicted adult height (PAH) were assessed every 6 months. Furthermore, 20 boys were followed up after treatment discontinuation until achievement of the final adult height (FAH).
RESULTS
The mean chronological age (CA) and bone age (BA) of the patients with CPP at treatment initiation were 9.5 ± 0.5 years and 11.7 ± 0.9 years, respectively. The mean duration of treatment was 2.87 ± 0.63 years. The PAH at treatment initiation was 172.1 cm (-0.23 ± 1.05 PAH standard deviation score). The PAH at treatment discontinuation (176.2 ± 6.6 cm) was significantly higher than the pretreatment PAH. In addition, the mean final adult height in the 20 boys who were followed up after discontinuation of treatment was 173.4 ± 5.8 cm, which was significantly higher than the initial PAH (170.1 ± 4.5 cm; p = 0.006). In multivariate analysis, the height gain (the difference between the FAH and PAH at treatment initiation) significantly correlated with the target height.
CONCLUSION
Long-term GnRHa treatment significantly improved the growth potential and FAH in boys with CPP.
目的
促性腺激素释放激素激动剂（GnRHa）治疗可提高中枢性性早熟（CPP）患者的身高增长潜力。然而，大多数研究都集中在女孩身上，因为男孩的 CPP 相对较少。因此，我们旨在确定 GnRHa 治疗对 CPP 男孩的体格发育结局的影响。
方法
85 例 CPP 男孩接受了 2 年的亮丙瑞林或醋酸曲普瑞林 3.75mg 治疗。每 6 个月评估一次人体测量学、骨龄、性成熟评分和预测成人身高（PAH）。此外，20 例男孩在治疗停止后继续随访至最终成年身高（FAH）。
结果
CPP 患者开始治疗时的平均年龄（CA）和骨龄（BA）分别为 9.5±0.5 岁和 11.7±0.9 岁。平均治疗时间为 2.87±0.63 年。治疗开始时的 PAH 为 172.1cm（-0.23±1.05 PAH 标准差评分）。治疗停止时的 PAH（176.2±6.6cm）明显高于治疗前的 PAH。此外，20 例停止治疗后随访的男孩的平均最终成年身高为 173.4±5.8cm，明显高于初始 PAH（170.1±4.5cm；p=0.006）。多元分析显示，身高增长（FAH 与治疗开始时 PAH 的差值）与靶身高显著相关。
结论
长期 GnRHa 治疗可显著提高 CPP 男孩的生长潜力和 FAH。
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