Effect of GnRH analogue on the bone mineral density of precocious or early pubertal girls |
Jeong Sook Lim, Heon-Seok Han |
Department of Pediatrics, Chungbuk National University, College of Medicine, Cheongju, Korea |
성조숙증 혹은 조기 사춘기가 있는 여아에서 단기간의 성선자극호르몬 방출호르몬 효능약제 사용이 골밀도에 미치는 영향 |
임정숙, 한헌석 |
충북대학교 의과대학 소아과학교실 |
Correspondence:
Heon-Seok Han, Email: hshan@chungbuk.ac.kr |
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Abstract |
Purpose : Treatment of precocity with gonadotropin releasing hormone analogue (GnRHa) might theoretically exert a detrimental effect on the bone mass during pubertal development. We investigated the short-term changes in bone mineral density (BMD) during GnRHa treatment and the enhancement in the changes with the co-administration of GnRHa and human growth hormone (hGH).
Methods : Forty girls with precocious or early puberty who were using GnRHa for more than 1 year were enrolled. Of them, 14 concurrently received hGH. Lumbar bone mineral density was measured before and after the treatment, and bone mineral density-standard deviation scores (BMD-SDSs) were compared according to chronologic age (CA) and bone age (BA), as well as according to the administration of GnRHa alone (Group I) or the co-administration of hGH and GnRHa (Group II).
Results : BMDs before and after treatment were in the normal range according to CA but were significantly lower according to BA (P<0.05). During treatment, BMD-SDSs did not change according to CA but significantly increased according to BA (P<0.05). BMD-SDSs in group I did not change during treatment according to CA or BA, while those in group II increased significantly according to BA (P<0.05), but not according to CA.
Conclusion : Lumbar BMD was adequate according to CA at initial manifestation of precocity but was lower if compared to BA, that is, BMD did not increase with BA. Because co-treatment with hGH significantly increased BMD-SDSs according to BA, hGH co-treatment could be considered during GnRHa therapy. |
Key Words:
Precocious puberty, Bone density, Gonadotropin releasing hormone, Human growth hormone |
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