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Ann Pediatr Endocrinol Metab > Volume 15(1); 2010 > Article
Growth Changes after One Year of Gonadotropin-Releasing Hormone Agonist Treatment in Idiopathic True Precocious Puberty Girls: Multicenter Study in Honam Area.
Eun Sung Kim, Sung Nam Jung, Min Sun Kim, Dae Yeol Lee, Chan Jong Kim, Jong Duck Kim, Eun Young Kim
1Department of Pediatrics, Gwangju Christian Hospital, Gwangju, Korea. eykim_kook@yahoo.com
2Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.
3Department of Pediatrics, Chonnam National University Medical School, Gwangju, Korea.
4Department of Pediatrics, Wonkwang University School of Medicine, Iksan, Korea.
We evaluated the effects of treatment with gonadotropin-releasing hormone agonist (GnRHa) on growth and sex hormone changes in idiopathic true precocious puberty girls. METHODS: From January 2003 through May 2007, forty-three female children, who were diagnosed as idiopathic true precocious puberty and were administered GnRHa for one year were enrolled in this retrospective study. We divided the patients into two groups according to midparental height (MPH) minus predicted adult height (PAH) (MPH-PAH > or = 5 cm, or MPH-PAH < 5 cm).
In total patients, post-treatment yearly growth velocity was 5.8+/-2.9 cm. Bone age advancement did not decline (2.4 +/- 1.2 years before treatment, and 2.1 +/- 0.3 years after treatment), so significant difference was not found in PAH before and after treatment (156.4 +/- 7.4 cm vs. 157.7 +/- 7.2 cm). But in a group who showed MPH minus PAH was 5 cm or more (MPH-PAH > or = 5 cm), height standard deviation score for bone age (Ht SDS for BA) was significantly increased before and after treatment (-1.8 +/- 0.7 vs. -1.3 +/- 0.8). PAH after treatment was increased to 153.6 +/- 5.8 cm from 149.1 +/- 4.6 cm before treatment (PAH gain 4.5 +/- 4.4 cm). Furthermore, as MPH-PAH increased, so did PAH gain (r = 0.59, P < 0.01). Height gain was positively correlated with bone age before treatment (r = 0.36, P < 0.05) and negatively correlated with PAH before treatment (r =-0.42, P < 0.01), and Ht SDS for BA (r = -0.38, P = 0.01) before treatment in total patients. The successful suppression of sex hormones and breast development were observed. The body mass index and body mass index percentile were increased after treatment.
The girls who showed MPH minus PAH was 5cm or more (MPH-PAH > or = 5 cm) before treatment attained significant height gain with GnRHa administration. The successful gonadal suppression was also observed.
Keywords: Vitamin D deficiency;Rickets;Alkaline phosphatase;Breast feeding


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