促性腺激素释放激素类似物治疗中枢性性早熟和早发性快速进展性青春期女童。
Gonadotropin-releasing hormone analogs treatment in girls with central precocious puberty and early fast puberty.
作者信息
Lerman Leiat, Yackobovitch-Gavan Michal, Phillip Moshe, Shalitin Shlomit
机构信息
The Jesse Z. and Sara Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
Pediatr Res. 2024 Mar;95(4):1051-1059. doi: 10.1038/s41390-023-02879-6. Epub 2023 Nov 7.
BACKGROUND
Gonadotropin-releasing hormone analog (GnRHa) is the standard treatment for children with central precocious puberty (CPP). We assessed efficacy and safety of GnRHa treatment in girls with CPP and early fast puberty (EFP).
METHODS
This retrospective observational study included anthropometric, clinical and laboratory data retrieved from medical files of girls with CPP or EFP, treated with GnRHa and followed at a tertiary endocrine clinic during 2007-2021.
RESULTS
For both CPP (n = 144) and EFP (n = 231) groups, mean height-SDS at GnRHa initiation and termination and at the last follow-up visit was greater than mid-parental height-SDS (P < 0.001). Only among girls with EFP, mean BMI-SDS was higher at treatment termination than initiation (P = 0.025). Median ages at menarche of the CPP and EFP groups were 11.8 and 12.0 years. Menstrual irregularities were reported in 20.3% of girls with CPP and in 18.7% of those with EFP. Adverse effects to treatment were reported in 3.5% and 3.9% of girls with CPP and EFP, respectively.
CONCLUSIONS
In this large cohort, GnRHa treatment in girls with EFP was effective without significant adverse effects as in those with CPP. A randomized controlled trial is required to examine the psychological impact of GnRHa treatment of variant early puberty.
IMPACT STATEMENT
Gonadotropin-releasing hormone analog (GnRHa) is the standard treatment for central precocious puberty (CPP). We assessed efficacy and safety of GnRHa treatment in girls with early fast puberty (EFP), characterized by pubertal signs between ages 8-9 years with fast pubertal signs advancement and accelerated growth and bone maturation and in girls with CPP. We found in this large cohort that GnRHa treatment in girls with EFP was effective and safe as in those with CPP. A prospective randomized controlled trial is required to examine the psychological impact of GnRHa treatment of variant early puberty.
背景
促性腺激素释放激素类似物（GnRHa）是中枢性性早熟（CPP）儿童的标准治疗方法。我们评估了GnRHa治疗CPP女童和早发性快速青春期（EFP）女童的疗效和安全性。
方法
这项回顾性观察性研究纳入了2007年至2021年期间在一家三级内分泌诊所接受GnRHa治疗并随访的CPP或EFP女童的人体测量、临床和实验室数据，这些数据均从她们的病历中获取。
结果
对于CPP组（n = 144）和EFP组（n = 231），GnRHa开始治疗时、治疗结束时以及最后一次随访时的平均身高标准差（SDS）均高于父母平均身高SDS（P < 0.001）。仅在EFP女童中，治疗结束时的平均体重指数标准差（BMI-SDS）高于开始治疗时（P = 0.025）。CPP组和EFP组的初潮中位年龄分别为11.8岁和12.0岁。报告显示，20.3%的CPP女童和18.7%的EFP女童出现月经不规律。CPP女童和EFP女童中分别有3.5%和3.9%报告了治疗的不良反应。
结论
在这个大型队列中，GnRHa治疗EFP女童与治疗CPP女童一样有效，且无明显不良反应。需要进行一项随机对照试验来研究GnRHa治疗变异型性早熟的心理影响。
影响声明
促性腺激素释放激素类似物（GnRHa）是中枢性性早熟（CPP）的标准治疗方法。我们评估了GnRHa治疗早发性快速青春期（EFP）女童（其特征为8至9岁出现青春期体征，青春期体征进展迅速，生长加速，骨骼成熟加快）和CPP女童的疗效和安全性。我们在这个大型队列中发现，GnRHa治疗EFP女童与治疗CPP女童一样有效且安全。需要进行一项前瞻性随机对照试验来研究GnRHa治疗变异型性早熟的心理影响。
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