用曲普瑞林治疗的特发性中枢性性早熟女孩的成年身高
Adult height in girls with idiopathic central precocious puberty treated with triptorelin.
作者信息
Corripio Raquel, Soriano-Guillén Leandro, Herrero Francisco-Javier, Castro-Feijoó Lidia, Escribano Aránzazu, Sol-Ventura Paula, Espino Rafael, Vela Amaia, Labarta José-Ignacio, Argente Jesús
机构信息
Pediatric Endocrine Department, Hospital de Sabadell, Corporació Parc Taulí, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain.
Pediatric Endocrinology Unit, Institute of Biomedical Research-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain.
出版信息
Front Endocrinol (Lausanne). 2024 Dec 5;15:1498726. doi: 10.3389/fendo.2024.1498726. eCollection 2024.
OBJECTIVE
Idiopathic central precocious puberty (CPP) precipitates epiphyseal fusion of growth plates in long bones, leading to reduced adult stature. Gonadotropin-releasing hormone analogues (GnRHa) are the treatment of choice for idiopathic CPP, but their benefit on height gain is unclear. We aimed to elucidate the effects of GnRHa treatment on adult height in girls with idiopathic CPP.
DESIGN
This prospective observational descriptive study analyzed data of girls with idiopathic CPP diagnosed at 55 centers in Spain between January 1, 1998 and December 31, 2012 included in the Spanish Society for Pediatric Endocrinology's national registry.
METHODS
We included girls with idiopathic CPP (thelarche < 8 years, positive LHRH stimulation test, bone age > 1 year older than chronological age, and normal brain imaging) treated with triptorelin (3.75 mg monthly, adjusted according to LHRH test results and clinical findings). We assessed weight, height, BMI, and secondary sexual characteristics every 6 months and bone age every 12 months until adult height (AH) was attained. The primary outcome was the difference between AH and target height (TH).
RESULTS
A total of 465 girls (18.90% adopted) were included; we analyzed data recorded at treatment end in 358 girls and at AH in 216. Mean difference between AH and TH was -1.5 (95%CI: -2.56- -0.45) cm and between AH and PAH 2,57 (95%CI:-3.56- -1.58) cm.
CONCLUSIONS
GnRHa treatment helps preserve genetic growth potential in girls with idiopathic CPP.
目的
特发性中枢性性早熟（CPP）会促使长骨生长板的骨骺融合，导致成年身高降低。促性腺激素释放激素类似物（GnRHa）是特发性CPP的首选治疗方法，但其对身高增长的益处尚不清楚。我们旨在阐明GnRHa治疗对特发性CPP女童成年身高的影响。
设计
这项前瞻性观察性描述性研究分析了1998年1月1日至2012年12月31日期间在西班牙55个中心诊断为特发性CPP的女童的数据，这些数据纳入了西班牙儿科内分泌学会的国家登记册。
方法
我们纳入了接受曲普瑞林治疗（每月3.75毫克，根据促黄体生成素释放激素试验结果和临床发现进行调整）的特发性CPP女童（乳房发育<8岁，促黄体生成素释放激素刺激试验阳性，骨龄比实际年龄大>1岁，且脑成像正常）。每6个月评估一次体重、身高、体重指数和第二性征，每12个月评估一次骨龄，直至达到成年身高（AH）。主要结局是AH与靶身高（TH）之间的差异。
结果
共纳入465名女童（18.90%为领养）；我们分析了358名女童治疗结束时记录的数据以及216名女童成年身高时的数据。AH与TH之间的平均差异为-1.5（95%置信区间：-2.56--0.45）厘米，AH与预测成年身高（PAH）2之间的平均差异为2.57（95%置信区间：-3.56--1.58）厘米。
结论
GnRHa治疗有助于保留特发性CPP女童的遗传生长潜力。
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