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葡萄牙中枢性性早熟队列中8岁后使用促性腺激素释放激素激动剂的身高益处。

Height benefit of GnRH agonists after age 8 in a Portuguese cohort of central precocious puberty.

作者信息

Castro Carolina, Espada Filipa, Leite Ana Luísa, Antunes Ana, Robalo Brígida, Amaral Daniela, Galo Elisa, Castro Sofia, Ferreira Sofia, Limbert Catarina

机构信息

Unit of Paediatric Endocrinology, Deparment of Paediatrics, Hospital Pedro Hispano, Porto, Matosinhos, Portugal.

Department of Paediatrics, Hospital CUF Porto, Porto, Portugal.

出版信息

Clin Endocrinol (Oxf). 2023 May;98(5):670-677. doi: 10.1111/cen.14884. Epub 2023 Feb 6.

Abstract

OBJECTIVE

Idiopathic central precocious puberty (iCPP) is common in paediatric endocrinology. Gonadotropin-releasing hormone agonists (GnRHa) are safe, but the effect on final height and the ideal timing for treatment remains controversial. This study aims to assess the effectiveness of GnRHa on growth outcomes in girls with iCPP treated before and after the age of 8 years old.

DESIGN AND PATIENTS

This retrospective longitudinal study evaluated data from Portuguese girls with iCPP who completed treatment between 2010 and 2021.

MEASUREMENTS

Auxological and clinical characteristics were compared according to age at treatment onset.

RESULTS

A cohort of 134 girls with iCPP, was divided into early treatment (ET) (<8 years, n = 48) and later treatment (LT) groups (≥8 years, n = 86). In both groups, most children presented with Tanner II and III. Tanner IV was more frequent in LT group (p = .003). At the end of treatment, predicted adult height increased in both groups (ET p = .032; LT p = .04) and bone age significantly slowed down in all participants (p = .008, p = .034). The height gain was greater in the ET group, but without significant differences (p = .065).

CONCLUSIONS

Treatment with GnRHa improved final height in all girls with iCPP, even when initiated after 8 years. To achieve better outcomes, treatment should be provided promptly after diagnosis.

摘要

目的

特发性中枢性性早熟(iCPP)在儿科内分泌学中很常见。促性腺激素释放激素激动剂(GnRHa)是安全的,但对最终身高的影响以及理想的治疗时机仍存在争议。本研究旨在评估GnRHa对8岁前后接受治疗的iCPP女童生长结局的有效性。

设计与患者

这项回顾性纵向研究评估了2010年至2021年间完成治疗的葡萄牙iCPP女童的数据。

测量

根据治疗开始时的年龄比较人体测量学和临床特征。

结果

134名iCPP女童队列被分为早期治疗(ET)组(<8岁,n = 48)和晚期治疗(LT)组(≥8岁,n = 86)。两组中,大多数儿童处于坦纳II期和III期。坦纳IV期在LT组中更常见(p = .003)。治疗结束时,两组的预测成年身高均增加(ET组p = .032;LT组p = .04),所有参与者的骨龄均显著减缓(p = .008,p = .034)。ET组的身高增长更大,但无显著差异(p = .065)。

结论

GnRHa治疗可改善所有iCPP女童的最终身高,即使在8岁以后开始治疗。为了取得更好的效果,应在诊断后及时进行治疗。

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