目的:促性腺激素释放激素(GnRHa)是治疗中枢性性早熟(CPP)的首选药物。然而,GnRHa对CPP患者内分泌系统的影响,包括胰岛素敏感性,血脂水平,甲状腺功能,骨矿物质密度(BMD),和睾丸激素(T)水平,目前是矛盾的。因此,GnRHa治疗的长期安全性仍存在争议.
背景:使用PubMed进行了系统的文献检索,Embase,科克伦图书馆,和CNKI数据库。HOMA-IR的变化,TG,LDL-C,HDL-C,TSH,FT3,FT4,T,通过Meta分析比较GnRHa治疗前后CPP患者的骨密度。由于研究之间的异质性,我们使用随机效应模型估计了标准差平均差(SMD)和95%置信区间(CI).Egger检验用于评估发表偏倚。
结论:共有22项研究纳入我们的meta分析。与GnRHa治疗前相比,包括HOMA-IR在内的内分泌指标差异无统计学意义,TG,LDL-C,HDL-C,TSH,FT4,FT3,T,用GnRHa治疗的CPP患者的BMD。
结论:用GnRHa治疗中枢性性早熟不会增加对内分泌系统的不良影响。
OBJECTIVE: Gonadotropin-releasing hormone (
GnRHa) is the first choice for the treatment of patients with central precocious puberty (CPP). However, the effects of
GnRHa on the endocrine system of CPP patients, including insulin sensitivity, lipid level, thyroid function, bone mineral density (BMD), and testosterone (T) level, are currently contradictory. Therefore, the long-term safety of
GnRHa therapy remains controversial.
BACKGROUND: A systematic literature search was performed using PubMed, Embase, Cochrane Library, and CNKI databases. The changes in HOMA-IR, TG, LDL-C, HDL-C, TSH, FT3, FT4, T, and BMD in CPP patients before and after
GnRHa treatment were compared by meta-analysis. As the heterogeneity between studies, we estimated standard deviation mean differences (SMDs) and 95 % confidence intervals (CIs) using a random-effects model. Egger\'s test was used to assess publication bias.
CONCLUSIONS: A total of 22 studies were included in our meta-analysis. Compared with before
GnRHa treatment, there were no statistically significant differences in endocrine indicators including HOMA-IR, TG, LDL-C, HDL-C, TSH, FT4, FT3, T, and BMD of CPP patients treated with GnRHa.
CONCLUSIONS: Treatment with GnRHa for central precocious puberty will not increase the adverse effect on the endocrine system.