Puberty and Pubertal Growth in GH-treated SGA Children: Effects of 2 Years of GnRHa Versus No GnRHa
| Autor: | Manouk van der Steen, Anita C. S. Hokken-Koèelega, Danielle C. M. van der Kaay, Annemieke J. Lem |
|---|---|
| Přispěvatelé: | Pediatrics |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Adolescent Endocrinology Diabetes and Metabolism Clinical Biochemistry Treatment outcome 030209 endocrinology & metabolism Context (language use) Biochemistry Gonadotropin-Releasing Hormone 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine medicine Humans 030212 general & internal medicine Child Growth Disorders business.industry Human Growth Hormone Biochemistry (medical) Puberty GnRH Analog Bone age medicine.disease Adult height Body Height Discontinuation Treatment Outcome Infant Small for Gestational Age Small for gestational age Female Leuprolide business Puberty onset |
| Zdroj: | Journal of Clinical Endocrinology and Metabolism, 101(5), 2005-2012. Endocrine Society |
| ISSN: | 0021-972X |
| DOI: | 10.1210/jc.2016-1317 |
| Popis: | Context: Most studies on puberty in children born small for gestational age (SGA) report height and age at onset of puberty. GH-treated SGA children with an adult height (AH) expectation below −2.5 SDS at onset of puberty can benefit from an additional 2 years of GnRH analog (GnRHa) treatment. There are no data on puberty and growth after discontinuation of GnRHa treatment in GH-treated SGA children. Objective: This study aimed to investigate the effects on puberty and pubertal growth of 2 years GnRHa vs no GnRHa in GH-treated SGA children. Methods: This was a GH trial involving 76 prepubertal short SGA children (36 girls) treated with GH. Thirty-two children received additional GnRHa for 2 years. Pubertal stages were 3-monthly assessed according to Tanner. Results: Age, bone age, and median height at pubertal onset were lower in girls and boys in the GH/GnRHa group compared with the GH group. In girls and boys treated with GH/GnRHa, pubertal duration after stop of GnRHa treatment was shorter than pubertal duration in those with GH only (40.9 vs 46.7 mo; P = .044; 50.8 vs 57.5 months; P = .006; respectively). Height gain from onset of puberty until AH, including height gain during 2 years of GnRHa treatment, was 25.4 cm in girls and 33.0 cm in boys, which was 6.6 cm more than girls and boys treated with GH only. AH was similar in children treated with GH/GnRHa compared with those with GH only. Conclusions: GH-treated SGA children who start puberty with an AH expectation below −2.5 SDS and are treated with 2 years of GnRHa have a shorter pubertal duration after discontinuation of GnRHa compared with pubertal duration in children treated with GH only. Height gain from onset of puberty until AH is, however, more due to adequate growth during 2 years of GnRHa treatment resulting in a similar AH as children treated with GH only. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|