Factors determining normal adult height in girls with gonadotropin-dependent precocious puberty treated with depot gonadotropin-releasing hormone analogs
Factors determining normal adult height in girls with gonadotropin-dependent precocious puberty treated with depot gonadotropin-releasing hormone analogs
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DOI：
10.1210/jc.2007-2183
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发表时间：
2008-07-01
影响因子：
5.8
通讯作者：
Mendonca, Berenice Bilharinho
中科院分区：
文献类型：
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作者：
Brito, Vinicius Nahime;Latronico, Ana Claudia;Mendonca, Berenice Bilharinho
目的：探讨影响促性腺激素依赖型性腺激素依赖性性早熟(GDPP)患者成年身高的因素。目的：探讨GnRH类似物治疗GDPP患者成年身高的影响因素。此外，对达到目标身高(TH)范围的女孩和没有达到目标身高范围的女孩的临床特征进行了比较。结果：女童身高平均值为155.3+/-6.9 cm(-1.2+/-1SD)，有81%的人达到了这个范围。多元回归分析显示，青春期开始至GnRH类似物治疗开始的时间间隔、治疗开始和结束时的身高标准差(SDSS)，可解释74%的AH变异。从Bayley和Pinneau的平均骨龄表中预测的GnRH治疗中断时的身高，在两性中都比晚期骨龄更准确。男童的平均HA值为170.6+/-9.2cM(-1+/-1.3SDS)，而TH值为89%。结论：决定GnRH类似物治疗的GDPP女孩正常HH值的主要因素是青春期开始至治疗开始的时间间隔较短，治疗开始和结束时较高的SDS值，以及治疗结束时较高的SDS值。因此，对GDPP患者进行及时的GnRH类似物治疗是获得正常AH的关键。
Context: Several factors can affect adult height (AH) of patients with gonadotropin-dependent precocious puberty (GDPP) treated with depot GnRH analogs.Objective: Our objective was to determine factors influencing AH in patients with GDPP treated with depot GnRH analogs.Patients: A total of 54 patients (45 girls) with GDPP treated with depot GnRH analog who reached AH was included in the study.Design: Univariate and multivariate analyses of the factors potentially associated with AH were performed in all girls with GDPP. In addition, clinical features of the girls who attained target height (TH) range were compared with those who did not. Predicted height using Bayley and Pinneau tables was compared with attained AH.Results: In girls the mean AH was 155.3 +/- 6.9 cm (-1.2 +/- 1 SD) with TH range achieved by 81% of this group. Multiple regression analysis revealed that the interval between chronological age at onset of puberty and at the start of GnRH analog therapy, height SD scores (SDSs) at the start and end of therapy, and TH explained 74% of AH variance. The predicted height at interruption of GnRH therapy, obtained from Bayley and Pinneau tables for average bone age, was more accurate than for advanced bone age in both sexes. In boys the mean AH was 170.6 +/- 9.2 cm (-1 +/- 1.3 SDS), whereas TH was achieved by 89% of this group.Conclusions: The major factors determining normal AH in girls with GDPP treated with depot GnRH analogs were shorter interval between the onset of puberty and start of therapy, higher height SDS at the start and end of therapy, and TH. Therefore, prompt depot GnRH analog therapy in properly selected patients with GDPP is critical to obtain normal AH.