Saggese G, Bertelloni S, Baroncelli G I, Battini R, Franchi G
Department of Paediatrics, University of Pisa, Italy.
Eur J Pediatr. 1993 Sep;152(9):717-20. doi: 10.1007/BF01953983.
Gonadal steroids drive the significant bone mineral increase that occurs at puberty. Oestrogen deprivation in women results in bone loss. We investigated bone mineralization by single photon absorptiometry in girls with central precocious puberty (n = 13, age 3.8-8.5 years) before and during 1 year of treatment with gonadotropin releasing hormone analogue (GnRH-a = long-acting D-Trp6-GnRH, 60 micrograms i.m. every 28 days). Before GnRH-a therapy, bone mineral density (BMD) was significantly higher in patients than in ten control girls matched for chronological age (patients 0.575 +/- 0.097 g/cm2, controls 0.433 +/- 0.049 g/cm2, P < 0.001). Patient BMD was not significantly different from that of ten control girls matched according to patient bone, age (0.550 +/- 0.046 g/cm2, P = NS). During GnRH-a treatment, pituitary-gonadal axis was suppressed and patient BMD significantly decreased (6 months: -6.0%, P < 0.002 vs baseline; 12 months: -8.0%, P < 0.001 vs baseline). We conclude that in girls with precocious puberty the activation of gonadal steroid secretion induces an increase in bone mineralization and that oestrogen deprivation by GnRH-a treatment caused a significant decrease in BMD.
性腺类固醇促使青春期出现显著的骨矿物质增加。女性雌激素缺乏会导致骨质流失。我们采用单光子吸收法对13名中枢性性早熟女童（年龄3.8 - 8.5岁）在使用促性腺激素释放激素类似物（GnRH - a =长效D - Trp6 - GnRH，每28天肌肉注射60微克）治疗前及治疗1年期间的骨矿化情况进行了研究。在GnRH - a治疗前，患者的骨密度（BMD）显著高于按实际年龄匹配的10名对照女童（患者0.575±0.097g/cm²，对照0.433±0.049g/cm²，P < 0.001）。患者的BMD与按患者骨龄匹配的10名对照女童相比无显著差异（0.550±0.046g/cm²，P =无显著性差异）。在GnRH - a治疗期间，垂体 - 性腺轴受到抑制，患者的BMD显著下降（6个月时：-6.0%，与基线相比P < 0.002；12个月时：-8.0%，与基线相比P < 0.001）。我们得出结论，在性早熟女童中，性腺类固醇分泌的激活会诱导骨矿化增加，而GnRH - a治疗导致的雌激素缺乏会使BMD显著下降。
