Chen Ming, Sun Jie-Yu, Ji Xing, Ni Ming-Ming
Department of Pharmacy, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.
Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Endocrine. 2025 Jun 23. doi: 10.1007/s12020-025-04332-6.
The aim of this meta-analysis was to evaluate the impact of gonadotropin-releasing hormone analog (GnRHa) treatment on height outcomes in girls aged over 6 years with central precocious puberty (CPP).
A systematic search was performed across PubMed, Cochrane Library, Web of Science, MEDLINE, EMBASE, CNKI, and Wan Fang databases to identify eligible studies. The meta-analysis protocol was registered at PROSPERO, and the quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was used to synthesize data on height gain, final adult height (FAH), FAH standard deviation score (SDS), bone age, and the difference between FAH and target height (TH).
Fifteen studies including 1270 girls were identified. The results indicated that GnRHa therapy significantly improves height outcomes in girls with CPP aged over 6 years. By effectively delaying pubertal progression and bone age maturation, GnRHa treatment enables these girls to achieve a greater FAH and potentially surpass their TH. Meta-analysis showed that the GnRHa treatment group demonstrated significantly greater height gain (WMD = 2.52, 95% CI [1.66, 3.37]), FAH (WMD = (WMD = 3.18, 95% CI [1.49, 4.87]), and FAH minus TH (WMD = 0.61, 95% CI [0.42, 0.79]) compared to the control group. Additionally, bone age (WMD = -1.02, 95%CI [-1.99, -0.06]) was significantly lower than the control group. However, FAH SDS showed no significant difference between the groups (WMD = 0.09, 95%CI [-0.40, 0.58]).
GnRHa treatment demonstrates substantial benefits in promoting height outcomes in girls over 6 years old with CPP. This meta-analysis contributes to the growing body of evidence supporting the efficacy of GnRHa in managing CPP and underscores the importance of early intervention to maximize height potential in affected individuals.
本荟萃分析旨在评估促性腺激素释放激素类似物（GnRHa）治疗对6岁以上中枢性性早熟（CPP）女童身高结局的影响。
在PubMed、Cochrane图书馆、科学网、MEDLINE、EMBASE、中国知网和万方数据库中进行系统检索，以确定符合条件的研究。荟萃分析方案已在PROSPERO注册，并使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。采用随机效应荟萃分析来综合身高增长、最终成年身高（FAH）、FAH标准差评分（SDS）、骨龄以及FAH与靶身高（TH）之间差异的数据。
共纳入15项研究，涉及1270名女童。结果表明，GnRHa治疗可显著改善6岁以上CPP女童的身高结局。通过有效延迟青春期进展和骨龄成熟，GnRHa治疗使这些女童能够获得更高的FAH，并有可能超过她们的TH。荟萃分析显示，与对照组相比，GnRHa治疗组的身高增长（加权均数差[WMD]=2.52，95%置信区间[CI][1.66, 3.37]）、FAH（WMD = 3.18，95%CI[1.49, 4.87]）以及FAH减去TH（WMD = 0.61，95%CI[0.42, 0.79]）显著更高。此外，骨龄（WMD = -1.02，95%CI[-1.99, -0.06]）显著低于对照组。然而，两组之间的FAH SDS无显著差异（WMD = 0.09，95%CI[-0.40, 0.58]）。
GnRHa治疗在促进6岁以上CPP女童身高结局方面显示出显著益处。本荟萃分析为支持GnRHa治疗CPP疗效的证据不断增加做出了贡献，并强调了早期干预对最大化受影响个体身高潜力的重要性。
