Municchi G, Rose S R, Pescovitz O H, Barnes K M, Cassorla F G, Cutler G B
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892.
J Clin Endocrinol Metab. 1993 Nov;77(5):1334-9. doi: 10.1210/jcem.77.5.8077329.
LH-releasing hormone agonist (LHRHa) treatment slows bone maturation and improves adult height in children with LHRH-dependent precocious puberty. To determine whether pubertal delay induced by LHRHa can enhance final height in patients with short stature and a normally timed puberty, we enrolled 43 short children (28 girls and 15 boys) in a double blind, placebo-controlled trial. Patients were assigned randomly to receive either placebo or LHRHa (deslorelin), administered sc at a dose of 4 micrograms/kg.day for a period of 4 yr. This report describes the preliminary results in 16 children who have completed 4 yr of treatment (9 patients in the deslorelin group and 7 patients in the placebo group). Predicted adult height increased significantly in the deslorelin-treated patients, by 7.6 cm compared to the pretreatment baseline and by 10.3 cm compared to that in the placebo-treated patients (P < 0.005). Four of the 16 patients received concurrent GH treatment (3 among the deslorelin-treated patients and 1 among the placebo-treated patients). Omitting these patients from the analysis did not materially affect the results: predicted adult height in the deslorelin-treated patients increased by 7.2 cm compared to the pretreatment baseline and by 10.9 cm compared to that in the placebo-treated patients (P < 0.005). We conclude that pubertal delay induced by deslorelin significantly increases predicted adult height in adolescents with short stature and a normally timed puberty. Whether deslorelin treatment will increase the final height of these patients cannot be determined until they have stopped growing.
促黄体生成素释放激素激动剂(LHRHa)治疗可减缓依赖LHRH的性早熟儿童的骨骼成熟并提高其成年身高。为了确定LHRHa诱导的青春期延迟是否能提高身材矮小且青春期时间正常的患者的最终身高,我们开展了一项双盲、安慰剂对照试验,纳入了43名身材矮小的儿童(28名女孩和15名男孩)。患者被随机分配接受安慰剂或LHRHa(地洛瑞林),皮下注射剂量为4微克/千克·天,为期4年。本报告描述了16名完成4年治疗的儿童的初步结果(地洛瑞林组9例,安慰剂组7例)。地洛瑞林治疗的患者预测成年身高显著增加,与治疗前基线相比增加了7.6厘米,与安慰剂治疗的患者相比增加了10.3厘米(P<0.005)。16名患者中有4名同时接受了生长激素治疗(地洛瑞林治疗的患者中有3名,安慰剂治疗的患者中有1名)。在分析中排除这些患者对结果没有实质性影响:地洛瑞林治疗的患者预测成年身高与治疗前基线相比增加了7.2厘米,与安慰剂治疗的患者相比增加了10.9厘米(P<0.005)。我们得出结论,地洛瑞林诱导的青春期延迟显著增加了身材矮小且青春期时间正常的青少年的预测成年身高。在这些患者停止生长之前,无法确定地洛瑞林治疗是否会增加他们的最终身高。