■本研究旨在探讨促性腺激素释放激素激动剂(GnRHa)对青春期早快女孩最终成年身高(FAH)的影响。
通过回顾2010年1月1日至2020年12月31日在MacKay儿童医院的儿科内分泌科诊所的医疗记录数据,进行了一项回顾性研究。治疗组包括109名患者,每月接受3.75mg,持续至少1年,而对照组由95名未接受治疗的女孩组成。
■治疗组在纳入时明显年龄较大(实际年龄(CA1),治疗vs.control,8.7vs.8.4年,p<0.001),骨龄更高(BA)(BA1,11.5vs.10.8年,p<0.001),BA1-CA1(2.7vs.2.2年,p<0.001),和较短的预测成人身高(PAH1)(153.3vs.157.1cm,p=0.005),显着低于其目标高度(Tht)(PAH1-Tht,-3.9vs.-1.3厘米,p=0.039)。GnRHa和对照组的FAHs相似(157.0vs.156.7cm,p=0.357),并且与他们的Tht没有显着差异(FAH与在GnRHa组中,157.0vs.157.0cm;对照组,156.7vs.157.0厘米)。在亚组分析中,在PAH1小于153cm和Tht的患者中,GnRHa治疗后FAH显着升高(154.0vs.152.0厘米,p=0.041),和那些CA1在8到9岁之间的人(158.0vs.155.4厘米,p=0.004)。我们将满意的FAH结果定义为FAH-PAH1≥5cm,重要因素是GnRHa治疗,PAH1比他们的短,年龄小于9岁,第一年的增长速度更快。
■GnRHa可有效恢复一些青春期早快的女孩的Tht,尤其是在PAH较差(PAH低于153厘米且短于目标高度)的人群中。开始治疗时年龄较小,治疗过程中生长速度较快,身高增长较好。
This study aimed to explore the impact of gonadotropin-releasing hormone agonists (GnRHa) on final adult height (FAH) in girls with early and fast puberty.
A retrospective study was conducted by reviewing data from the medical records of the Pediatric Endocrinology Clinics between January 1, 2010, and December 31, 2020, at MacKay Children\'s Hospital. The treatment group included 109 patients who received 3.75 mg monthly for at least 1 year, whereas the control group consisted of 95 girls who received no treatment.
The treatment group was significantly older at the time of inclusion(chronological age (CA1), treatment vs. control, 8.7 vs. 8.4 years, p < 0.001), had a more advanced bone age (BA) (BA1, 11.5 vs. 10.8 years, p < 0.001), BA1-CA1 (2.7 vs. 2.2 years, p < 0.001), and shorter predicted adult height (PAH1) (153.3 vs. 157.1 cm, p = 0.005) that was significantly lower than their target height (Tht)(PAH1-Tht, -3.9 vs. -1.3 cm, p = 0.039). The FAHs of the GnRHa and the control group were similar (157.0 vs. 156.7 cm, p = 0.357) and were not significantly different from their Tht (FAH vs. Tht in the GnRHa group, 157.0 vs. 157.0 cm; control group, 156.7 vs. 157.0 cm). In the subgroup analysis, FAH was significantly higher after GnRHa treatment in those with PAH1 less than 153 cm and Tht (154.0 vs. 152.0 cm, p = 0.041), and those whose CA1 was between 8 and 9 years (158.0 vs. 155.4 cm, p = 0.004). We defined satisfactory FAH outcome as FAH-PAH1≥5 cm and significant factors were GnRHa therapy, PAH1 shorter than their Tht, age younger than 9 years, and faster growth velocity during the first year.
GnRHa is effective in restoring the Tht in some early and fast pubertal girls, especially in those with poorly PAH (PAH lower than 153 cm and shorter than their target height). A younger age at initiation of treatment and a faster growth velocity during treatment are associated with a better height gain.