Effects of gonadotropin-releasing hormone analogue on relationship between somatotropin axis function and growth velocity of girls with idiopathic central precocious puberty.

doi:10.11852/zgetbjzz2016-24-01-19

Abstract

Abstract: Objective To recognize the effects and relationship between somatotropin axis function and growth velocity in girls with idiopathic central precocious puberty (ICPP) treated with gonadotropin-releasing hormone analogue (GnRHa),and provide a theoretical basis for new treatments to cure growth deceleration after GnRHa therapy. Methods A total of 27 girls with ICPP treated with GnRHa were studied prospectively.Their height,bone age (BA),serum insulin-like growth factor-1 (IGF-I) and IGF binding protein-3 (IGFBP-3) concentrations at the beginning and the end of one year of GnRHa treatment were measured.The standard deviation scores (SDSs) of their height,BA,IGF-I,and IGFBP-3 concentrations according to their age at the beginning and the end of one year of GnRHa treatment were calculated. Results After one-year GnRHa treatment,height SDS for CA(HtSDSCA) significantly decreased from 1.03±0.74 to 0.83±0.73 (P<0.001),but height SDS for BA(HtSDSBA) increased from (-0.56±0.78) to (-0.26±0.65) (P<0.001).There was no significant change in serum IGF-I SDS,IGFBP-3 SDS,and IGF-I/IGFBP-3 ratio(P>0.05).The advanced BA was the factor most strongly correlated to the height velocity (R=0.291,P<0.05). Conclusions There is no significant change in serum IGF-I SDS,IGFBP-3 SDS,and IGF-I/IGFBP-3 ratio after GnRHa treatment.The height velocity affected by GnRHa treatment may due to other mechanism than suppression of the IGF-I secretory axis.

Key words: central precocious puberty, gonadotropin-releasing hormone analogues, somatotropin axis, growth velocity

摘要： 目的探讨促性腺激素释放激素类似物(GnRHa)治疗女童特发性中枢性性早熟(ICPP)对促生长素轴功能与生长速度关系的影响,为GnRHa治疗后出现的生长减速寻找新的治疗方法提供理论依据。方法对接受GnRHa治疗的27例ICPP女童,观察在治疗开始以及治疗1年后其身高、骨龄、血清胰岛素样生长因子I(insulin-like growth factor-1,IGF-I)以及胰岛素生长因子结合蛋白3(IGFBP-3)等数据。依据她们的年龄分别计算身高、骨龄、IGF-I以及IGFBP3的标准差积分(SDS)。结果 ICPP患儿GnRHa治疗1年后,按实际年龄的身高SDS从1.03±0.74下降至0.83±0.73(P<0.001),按骨龄的身高SDS从-0.56±0.78增至-0.26±0.65(P<0.001)。治疗前后IGF-I SDS,IGFBP-3 SDS以及IGF-I/IGFBP-3差异无统计学意义(P>0.05)。与身高生长速度相关性最强的是提前的骨龄(R=0.291,P<0.05)。结论 ICPP患儿GnRHa治疗前后IGF-I、IGFBP-3均无明显改变,GnRHa可能是通过抑制IGF-I分泌轴之外的机制来影响身高生长速度。

关键词: 中枢性性早熟, 促性腺激素释放激素类似物, 促生长素轴, 生长速度

CLC Number:

R179

LIN Cui-lan,WEI Wan-jian,HE Wan-yi,LIU Yu-ling.. Effects of gonadotropin-releasing hormone analogue on relationship between somatotropin axis function and growth velocity of girls with idiopathic central precocious puberty.[J]. journal1, 2016, 24(1): 65-67.

林翠兰,韦婉俭,何婉懿,刘玉玲. 促性腺激素释放激素类似物对特发性中枢性性早熟女童促生长素轴与生长速度的影响[J]. 中国儿童保健杂志, 2016, 24(1): 65-67.

References

[1] 中华人民共和国卫生部.性早熟诊疗指南(试行)【卫办医政发(195)号】[J].中国儿童保健杂志,2011,19(4):390-392.
[2] Gillis D,Karavani G,Hirsch HJ,et al.Time to menarche and final height after histrelin implant treatment for central precocious puberty[J].J Pediatr,2013,163(2):532-536.
[3] 马华梅.儿童性早熟药物治疗进展[J].实用儿科临床杂志,2011,26(8):553-557.
[4] Yi KH.Serum IGF-1 and IGFBP-3 levels in central precocious puberty girls treated with gonadotropin releasing hormone agonist (GnRHa) [J].J Korean Soc Pediatr Endocrinol,2011,16(3):20-23.
[5] 叶义言.中国儿童骨龄评分法[M].北京:人民卫生出版社,2005:11-55.
[6] 李辉,季成叶,张亚钦,等.中国0～18岁儿童身高体重的标准化生长曲线[J].中华儿科杂志,2009,47(7):487-492.
[7] 许珊珊,顾学范,潘慧,等.儿童青少年血清胰岛素生长因子-1及胰岛素因子结合蛋白-3的正常参考值研究[J].临床儿科杂志,2009,27(12):1105-1110.
[8] 中华医学会儿科分会内分泌遗传代谢学组青春发育调查研究协作组.中国九大城市女性儿童第二性征发育和初潮年龄调查[J].中华内分泌代谢杂志,2010,26(8):669-675.
[9] Yum T,Lee S,Kim Y.Association between precocious puberty and some endocrine disruptors in human plasma[J].J Environ Sci Health A Tox Hazard Subst Environ Eng,2013,48(8):912-917.
[10] Poli F,Pizza F,Mignot E,et al.High prevalence of precocious puberty and obesity in childhood narcolepsy with cataplexy[J].Sleep,2013,36(2):175-181.
[11] Lee HS,Park HK,Ko JH,et al.Utility of Basal luteinizing hormone levels for detecting central precocious puberty in girls[J].Horm Metab Res,2012,44(11):851-854.
[12] Park HK,Lee HS,Ko JH,et al.The effect of gonadotrophin-releasing hormone agonist treatment over 3 years on bone mineral density and body composition in girls with central precocious puberty[J].Clin Endocrinol (Oxf),2012,77(5):743-748.
[13] 林小梅,文飞球,吴本清,等.性早熟女性患儿血清IGF-1和IGFBP-3质量浓度检测及临床价值[J].中国实用儿科杂志,2005,20(4):212-214.
[14] 马华梅,杜敏联.GnRHa对特发性中枢性性早熟女童生长的影响[J].中山大学学报:医学科学版,2003,24(2):156-160.
[15] Walvoord EC,Pescovitz OH.Combined use of growth hormone and gonadotropin-releasing hormone analogues in precocious puberty:theoretic and practical considerations[J].Pediatrics,1999,104(4Pt 2):1010-1014.
[16] Weise M,Flor A,Bames KM,et al.Determinants of growth during gonadotropin-releasing hormone analog therapy for precocious puberty[J].J Clin Endocrinol Metab,2004,89(1):103-107.
[17] Kim YJ,Lee HS,Lee YJ,et al.Multicenter clinical trial of leuprolide acetate depot (Luphere depot 3.75 mg) for efficacy and safety in girls with central precocious puberty[J].Ann Pediatr Endocrinol Metab,2013,18(4):173-178.
[18] Inman M,Hursh BE,Mokashi A,et al.Occurrence of slipped capital femoral epiphysis in children undergoing gonadotropin?releasing hormone agonist therapy for the treatment of central precocious puberty[J].Horm Res Paediatr,2013,80(1):64-68.