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KMID : 0648420060110020162
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Journal of Korean Society of Pediatric Endocrinology
2006 Volume.11 No. 2 p.162 ~ p.169
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Effect of Gonadotropin Releasing Hormone Agonist on Growth and Sex Hormone in Girls with Early Puberty
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Chae Hyun-Wook
Koh Hong
Rhie Young-Jun
Kim Ho-Seong
Kim Duk-Hee
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Abstract
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Purpose: Gonadotropin releasing hormone agonist (GnRHa) treatment is widely used in precocious puberty to delay rapid pubertal growth and increase final height. But, girls who enter puberty 8 to 9 years also have same course with precocious puberty in many cases. Therefore GnRHa treatment is used in girls with early puberty, but the effects are controversial. We analyzed growth velocity and sex hormone concentrations in early puberty during and after GnRHa treatment.
Methods: The subjects were included 77 girls who had sexual development during 8 to 9 years, and they were treated with GnRHa over 6 months. We analyzed chronologic age (CA), bone age (BA), predicted adult height (PAH), breast development and serum LH, FSH, E2 levels during and after treatment. Additionally we analyzed height and growth velocity of 17 subjects who were treated with GnRHa plus GH.
Results: CA was 8.7±1.1 yrs and BA was 10.3±1.7 yrs at diagnosis. Growth velocity was decreased from 7.4±2.0 cm/yr to 4.9±1.1 cm/yr during treatment, but they were increased to 7.9±1.7 cm/yr in 6 months off treatment. PAH SDS was increased from -1.9±1.6 to -1.5±1.5 during treatment. Serum E2 levels were decreased from 16.1±8.7 ng/dL to 9.4±2.4 ng/dL in 3 months after treatment and maintained in low level during treatment. But they began to increase at 3 months off treatment (P= 0.059). Breast development was decreased in 3 months after treatment, however it began to increase in 3 months off treatment. Growth velocities were increased from 4.7 cm/yr to 6.6 cm/yr in 3months after combination treatment of GnRHa plus GH. PAH SDS was significantly increased in GnRHa plus GH treatment compared to GnRHa treatment only.
Conclusion: GnRHa treatment suppressed rapid progress of early puberty effectively from start of treatment. It could be useful to relieve psychosocial problems in early puberty. PAH SDS was increased during GnRHa treatment, but it was increased more in GnRHa plus GH treatment. GH combination treatment should be considered if growth velocity was decreased seriously.
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KEYWORD
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Gonadotropin releasing hormone agonist, Early puberty, Precocious puberty, Growth hormone, Sex hormone
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