Zhou Bo, Qu Xia, Wang Jianhong, Xu Qi, Zhang Lili, Wang Xi, Peng Nan, Gu Jialu, Zhang Xiaoqian, Wang Qiong, Niu Wenquan, Wang Lin
Child Healthcare Center, Capital Center for Children's Health, Capital Medical University, Beijing, China.
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Front Pediatr. 2025 Aug 29;13:1519746. doi: 10.3389/fped.2025.1519746. eCollection 2025.
We aimed to assess the effects of gonadotrophin-releasing hormone agonist (GnRHa) therapy on metabolic changes by synthesizing results from clinical trials involving children with idiopathic central precocious puberty (ICPP).
Literature search, trial selection, data extraction and quality assessment were completed independently by two investigators. STATA software (version 14.1) was used for data analyses. Effect-size estimates are expressed as weighted mean difference (WMD) with 95% confidence interval (CI).
This meta-analysis was conducted based on 19 clinical trials and 1,553 ICPP children. Overall analyses showed that for body mass index standard deviation score (BMISDS), no significance was noted after administering GnRHa to children with ICPP (WMD: -0.08; 95% CI: -0.22-0.06; = 0.269). Similarly, no significance was noted for total cholesterol (WMD: 1.94 mg/dl; 95% CI: -10.29-14.17; = 0.756), triglyceride (WMD: -5.31 mg/dl; 95% CI: -26.92-16.29; = 0.630) and low-density lipoprotein (WMD: -9.63 mg/dl; 95% CI: -40.09-20.83; = 0.535). By contrast, a statistically higher high-density lipoprotein of 7.07 mg/dl after administering GnRHa to children with ICPP (95% CI: 3.00-11.14; = 0.001). Subgroup and meta-regression analyses revealed that initial body weight, sample size, and age were significant sources of between-trial heterogeneity. There was a low probability of publication bias for above comparison, as indicated by Egger's tests.
Our meta-analytical findings indicate that GnRHa treatment did not appear to increase BMI and lipid metabolism levels in children with ICPP, irrespective of obesity status at the time of initiation therapy.
PROSPERO (CRD42023410554).
我们旨在通过综合涉及特发性中枢性性早熟（ICPP）儿童的临床试验结果，评估促性腺激素释放激素激动剂（GnRHa）治疗对代谢变化的影响。
两名研究者独立完成文献检索、试验筛选、数据提取和质量评估。使用STATA软件（版本14.1）进行数据分析。效应量估计值以加权平均差（WMD）及其95%置信区间（CI）表示。
本荟萃分析基于19项临床试验和1553例ICPP儿童进行。总体分析显示，对于ICPP儿童，给予GnRHa后体重指数标准差评分（BMISDS）无显著变化（WMD：-0.08；95%CI：-0.22 - 0.06；P = 0.269）。同样，总胆固醇（WMD：1.94mg/dl；95%CI：-10.29 - 14.17；P = 0.756）、甘油三酯（WMD：-5.31mg/dl；95%CI：-26.92 - 16.29；P = 0.630）和低密度脂蛋白（WMD：-9.63mg/dl；95%CI：-40.09 - 20.83；P = 0.535）也无显著变化。相比之下，ICPP儿童给予GnRHa后，高密度脂蛋白在统计学上显著升高7.07mg/dl（95%CI：3.00 - 11.14；P = 0.001）。亚组分析和荟萃回归分析显示，初始体重、样本量和年龄是试验间异质性的重要来源。Egger检验表明，上述比较存在发表偏倚的可能性较低。
我们的荟萃分析结果表明，GnRHa治疗似乎不会增加ICPP儿童的BMI和脂质代谢水平，无论起始治疗时的肥胖状况如何。
PROSPERO（CRD42023410554）
