National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, The Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Pediatr Endocrinol Metab. 2023 Jul 3;36(8):726-731. doi: 10.1515/jpem-2023-0118. Print 2023 Aug 28.
Case reports show hypertension in children treated with GnRH analogues for central precocious puberty (CPP). However, relevant data on blood pressure are scarce. We aimed to evaluate blood pressure (BP) among girls with idiopathic CPP and early-onset puberty before and during GnRH analogue therapy; and to examine associations of blood pressure with clinical parameters.
For this retrospective longitudinal cohort study, demographic, anthropometric, clinical, and laboratory data were collected from electronic files. The study group included 112 girls with idiopathic CPP or early-onset puberty followed in a tertiary pediatric endocrinology institute, and a control group of 37 healthy pre-pubertal girls. The main outcome measures were BP percentile, before, and during treatment with GnRH analogue.
At baseline, similar proportions of the study and control groups had BP values>90th percentile: 64 (53 %) and 17 (46 %), respectively (p=0.57). The mean systolic and diastolic BP percentiles measured under treatment remained unchanged. In the study group, baseline BP>90th percentile compared to normal baseline BP was associated with lower birthweight and a higher body mass index-standard deviation score: 2,821 ± 622 vs. 3,108 ± 485 g and 1.0 ± 0.7 vs. 0.70 ± 0.8, respectively, p=0.01 for both.
GnRH analogue therapy for precocious or early puberty was not associated with increased blood pressure. The stability of mean blood pressure percentile during treatment is reassuring.
病例报告显示,接受 GnRH 类似物治疗中枢性性早熟(CPP)的儿童会出现高血压。然而,有关血压的数据很少。我们旨在评估特发性 CPP 和青春期前性早熟女孩在 GnRH 类似物治疗前后的血压,并检查血压与临床参数的相关性。
这项回顾性纵向队列研究从电子档案中收集了人口统计学、人体测量学、临床和实验室数据。研究组包括在一家三级儿科内分泌研究所接受治疗的 112 名特发性 CPP 或青春期前性早熟女孩,以及 37 名健康的青春期前女孩作为对照组。主要观察指标为治疗前和治疗期间的血压百分位数。
在基线时,研究组和对照组有相似比例的血压值>90 百分位:分别为 64 名(53%)和 17 名(46%)(p=0.57)。治疗期间测量的收缩压和舒张压的平均百分位数保持不变。在研究组中,与正常基线血压相比,基线血压>90 百分位与较低的出生体重和较高的体重指数标准差评分相关:分别为 2,821±622 与 3,108±485 g 和 1.0±0.7 与 0.70±0.8,两者均 p=0.01。
促性腺激素释放激素类似物治疗性早熟或青春期前性早熟与血压升高无关。治疗期间平均血压百分位数的稳定性令人安心。