All issues > Volume 52(12); 2009

Original Article

Korean J Pediatr. 2009;52(12):1370-1376. Published online December 15, 2009.

Effect of GnRH analogue on the bone mineral density of precocious or early pubertal girls

Jeong Sook Lim¹, Heon-Seok Han¹

¹Department of Pediatrics, Chungbuk National University, College of Medicine, Cheongju, Korea

Correspondence Heon-Seok Han ,Email: hshan@chungbuk.ac.kr

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.

Keywords :Precocious puberty, Bone density, Gonadotropin releasing hormone, Human growth hormone