促性腺激素释放激素类似物对特发性中枢性性早熟女童体重指数影响的长期观察

Impact of gonadotropin-releasing hormone analogs on body mass index in girls with idiopathic central precocious puberty:a long-term follow-up study

目的动态研究促性腺激素释放激素类似物(GnRHa)治疗对特发性中枢性性早熟(ICPP)女童体重指数(BMI)的影响。方法对2003年1月至2006年1月确诊为ICPP的134例女童进行随访研究,其中57例给予GnRHa治疗(疗程1.69±0.43年),测量治疗前、治疗结束时及近成年身高时的身高、体重、骨龄及BMI等,并与未治疗组(77例)比较。结果 (1)GnRHa治疗组在治疗结束时的预测终身高标准差分值(SDS)较治疗前明显升高(P<0.01),与靶身高SDS接近(P>0.05),且近成年身高SDS明显高于靶身高SDS(P<0.01)。(2)GnRHa治疗组治疗结束时BMI SDS略有升高,但差异无统计学意义(P>0.05);近成年身高时的BMI SDS比治疗前和未治疗组明显降低(P<0.01),但治疗前、治疗结束时及近成年身高时BMI平均值都在±1SD内,处于正常范围。结论 GnRHa对改善ICPP女童终身高有显著疗效;GnRHa治疗后的BMI改变处于正常范围。

Objective To study the impact of gonadotropin-releasing hormone analogs（GnRHa） on body mass index（BMI） in girls with idiopathic central precocious puberty（ICPP）.Methods One hundred and thirty-four girls with ICPP were enrolled.Fifty-seven out of the 134 girls were treated with GnRHa for 1.69±0.43 years.The height,weight,bone age and BMI were measured before treatment,at the end of the treatment and after reaching near adult height and compared with those in the untreated 77 girls.Results The adult predicted height standard deviation score（SDS） at the end of treatment was significantly higher than that before treatment（P0.01） and was similar to the target height SDS in the GnRHa treatment group（P0.05）.With GnRHa treatment,the near-adult height SDS was higher than the target height SDS（P0.01）.At the end of treatment,the BMI SDS slightly increased compared with pretreatment level（P0.05）.A significant reduction in the BMI was observed when reaching the near-adult height in the GnRHa treatment group compared to the level of pretreatment and the untreated group（P0.01）.However,the BMI in the GnRHa treatment group before treatment,at the end of the treatment and after reaching near adult height remained in the normal range（±1 SD）.Conclusions GnRHa may improve the final height in girls with ICPP.The alterations of BMI after GnRHa therapy fluctuate in a normal range.