Long-term outcome after deport gonadotropin-releasing hormone agonist treatment of central precocious puberty: Final height, body proportions, body composition, bone mineral density, and reproductive function
Long-term outcome after deport gonadotropin-releasing hormone agonist treatment of central precocious puberty: Final height, body proportions, body composition, bone mineral density, and reproductive function
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DOI：
10.1210/jc.84.12.4583
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发表时间：
1999-12-01
影响因子：
5.8
通讯作者：
Sippell, WG
中科院分区：
文献类型：
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作者：
Heger, S;Partsch, CJ;Sippell, WG
相当多接受长效GnRH激动剂治疗的中枢性早熟（CPP）患者已达到最终身高（FH）。这项前瞻性、多中心研究的目的是评价长效GnRH激动剂治疗的获益、副作用和长期结局。我们调查了FH的50名年轻女性（平均+/- SD年龄，16.7 +/- 2.6岁;范围，12.9-23.4岁）。他们在4.4 +/- 2.1年（范围，1.0-9.7年）的时间内接受了长效曲普瑞林。治疗开始时的目标身高（TH）和预测成人身高（PAH）分别为163.6 +/- 6.2和154.9 +/- 9.6 cm（P < 0.05）。FH为160.6 ± 8.0 cm（FH与TH，P = NS; FH与PAH，P < 0.05）。年轻患者的身高增长最高（FH减去初始PAH）。78%的患者在TH范围内达到FH。即使在年轻患者和初始PAH低于TH范围的患者中，60%的患者在其个体TH范围内达到FH。腰椎（L1-L4）的标准化骨密度和标准化骨密度SD评分分别为1040.9 +/- 124.2 mg/cm（2）和0.0 +/- 1.0;股骨颈的标准化骨密度和标准化骨密度SD评分分别为902.2 +/- 115.4 mg/cm（2）和0.2 +/- 1.0。坐高/小腿长比值的so评分正常（0.3 ± 1.2）。治疗前、治疗结束时和FH时的体重指数sn评分无显著差异（分别为2.0 ± 2.0、2.0 ± 2.0和1.7 ± 2.2）。所有患者的初潮或初潮开始于12.3 ± 1.4岁（范围9.3-15.8岁）。总之，CPP女孩的长期长效GnRH激动剂治疗保留了遗传身高潜力，并显著改善FH，同时保持正常的身体比例。未观察到对骨密度和生殖功能的负面影响。治疗既不引起也不加重肥胖。
A considerable number of patients with central precocious puberty (CPP) treated with depot GnRH agonists have reached final height (FH). The aim of this prospective, multicentric study was the evaluation of the benefits, side-effects, and long term outcome of depot GnRH agonist therapy. We investigated 50 young women (mean +/- SD age, 16.7 +/- 2.6 yr; range, 12.9-23.4 yr) at FH. They received depot triptorelin over a period of 4.4 +/- 2.1 yr (range, 1.0-9.7 yr). Target height (TH) and predicted adult height (PAH) at the start of treatment were 163.6 +/- 6.2 and 154.9 +/- 9.6 cm, respectively (P < 0.05). FH was 160.6 +/- 8.0 cm (FH vs. TH, P = NS; FH vs. PAH, P < 0.05). Young patients showed the highest height gain (FH minus initial PAH). Seventy-eight percent of all patients reached a FH within their TH range. Even in young patients and those with an unfavorable initial PAH below the TH range, 60% reached a FH within their individual TH range. Standardized bone mineral density and standardized bone mineral density SD score investigated by dual energy x-ray absorptiometry of the lumbar spine (L1-L4) were 1040.9 +/- 124.2 mg/cm(2) and 0.0 +/- 1.0; those of the femoral neck were 902.2 +/- 115.4 mg/cm(2) and 0.2 +/- 1.0, respectively. The so score of the ratio of sitting height over lower leg length was normal (0.3 +/- 1.2). Body mass index sn scores at pretreatment, at the end of treatment, and at FH were not significantly different (2.0 +/- 2.0, 2.0 +/- 2.0, and 1.7 +/- 2.2, respectively). Menarche or remenarche started at age 12.3 +/- 1.4 yr (range, 9.3-15.8 yr) in all patients.In conclusion, long term depot GnRH agonist treatment of CPP girls preserved genetic height potential and improved FH significantly combined with normal body proportions. No negative effect on bone mineral density and reproductive function was seen. Treatment neither caused nor aggravated obesity.