진성 성조숙증 여아에서 Gonadotropin-Releasing Hormone Agonist 치료 중 성장속도에 따른 임상 인자들의 비교

Abstract

Background: The aim of this study was to investigate the favorable factors for gonadotropin-releasing hormone (GnRH) agonist treatment with regard to the growth velocity and the predicted adult height (PAH) in central precocious puberty (CPP) girls. Methods: We reviewed the clinical and auxological parameters in 46 CPP girls who were treated with GnRH agonist at the pediatric endocrinology clinic of Korea University Hospital from January 2001 to August 2007. We divided the two groups according to the growth velocity of 5 cm/yr and we assessed the related factors associated with growth velocity. We also assessed the changes in PAH for two years. Results: The pretreatment chronological age and bone age were significantly younger in the high growth velocity group (> 5 cm/yr)compared to that of the low growth velocity group (7.8 ± 0.9 year vs. 8.4 ± 0.5 year, 9.4 ± 1.2 year vs. 10.1 ± 0.9 year, respectively) (P <0.05). The PAH after treatment was significantly greater in the high growth velocity group (> 5 cm/yr)(P < 0.05). Growth velocity during treatment had negative correlation with the pretreatment chronological age and positive correlation with the PAH after one and two years of treatment (r = -0.45, P < 0.05 and r = 0.51, P < 0.01). PAH had positive correlation with the treatment duration (r = 0.31, P < 0.05). Conclusion: In our study, the growth velocity during GnRH agonist treatment was negatively related to age at the initiation of treatment. Therefore, earlier treatment is important to improve the outcomes and to maintain appropriate growth velocity in CPP girls.