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The Effect of Long-Acting Gonadotropin-Releasing Hormone (GnRH) Analog on the Growth Velocity and Final Adult Height in the Children with True Precocious Puberty

Journal of the Korean Pediatric Society 1994;37(3):309-316.
Published online March 15, 1994.
The Effect of Long-Acting Gonadotropin-Releasing Hormone (GnRH) Analog on the Growth Velocity and Final Adult Height in the Children with True Precocious Puberty
Sei Won Yang, Hyung Ro Moon
Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea
Long-acting Gonadotropin Releasing Hormone Analog가 성장속도 및 최종 예측 성인신장에 미치는 영향
양세원, 문형로
서울대학교 의과대학 소아과학교실
Abstract
The final adult height in the children with true precocious puberty are destined to be short due to excessive bone maturation, compared to the growth velocity, regardless of its etiologies. To improve this final shortness, long-acting GnRH analog have been tried to the children with true precocious puberty. We evaluated the parameters of the growth, including the growth velocity, height SDS, predicted final adult height obtained by Bayley-Pinneau method in the 12 children with true precocious puberty after treatment of long-acting GnRH analog, Decapeptyl. The results were as belows; 1) The mean age of pubertal onset was 5.0¡¾2.9 year of age (1~8.6 years of age). The bone age (10.2¡¾3.5 years of age) at diagnosis were significantly higher than the chronological age (7.2¡¾3.0)(Fig. 1, p<0.001). 2) During treatment with Decapeptyl, the progression of bone maturation seemed to be reduced, compared to the progression of chronological age, but there was no statistically significant difference (p>0.05). 3) The responses of LH and FSH to GnRH administration at 6 months of treatment with Decapeptyl were significantly reduced to prepubertal level, compared to those before the initiation of Decapeptyl treatment. 4) The height SDS before and at the first year of treatment with Decapeptyl were 1.5¡¾0.3 and 1.4¡¾0.2, which had no significant change during treatment (Fig. 3, p>0.05). But the height velocity during the first year of treatment (4.9¡¾1.7cm/year) was significantly reduced, compared to the height velocity during the one year before treatment (10.1¡¾1.5cm/year)(Fig. 4, p=0.01). 5) The predicted final adult height, obtained by Bayley-Pinneau method, at second year of treatment (174.4¡¾1.8cm) were significantly improved, compared to those at initial treatment (151.7¡¾2.3cm) and 6 months of treatment (156.9¡¾2.5cm)(Fig. 5, p<0.05). 6) The predicted final adult height, obtained at the first year of treatment had significant inverse correlation with the bone age at the initiation of treatment with Decapeptyl (Fig. 6, p<0.05, r=-0.84), but had no corrleation with the chronological age at the initiation of treatment. 7) During this study, we could not find any adverse reaction, which could come with the therapy of Decapeptyl, such as facial flushing and hypotension. With these result, we can conclude that the final adult height can be improved if true precocious puberty could be diagnosed early and treatment with long-acting GnRH analog be given early.
Key Words: Long-acting GnRH analog, Final Adult Height


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