Abstract: Objective To recognize the effects and relationship between somatotropin axis function and growth velocity in girls with idiopathic central precocious puberty (ICPP) treated with gonadotropin-releasing hormone analogue (GnRHa),and provide a theoretical basis for new treatments to cure growth deceleration after GnRHa therapy. Methods A total of 27 girls with ICPP treated with GnRHa were studied prospectively.Their height,bone age (BA),serum insulin-like growth factor-1 (IGF-I) and IGF binding protein-3 (IGFBP-3) concentrations at the beginning and the end of one year of GnRHa treatment were measured.The standard deviation scores (SDSs) of their height,BA,IGF-I,and IGFBP-3 concentrations according to their age at the beginning and the end of one year of GnRHa treatment were calculated. Results After one-year GnRHa treatment,height SDS for CA(HtSDSCA) significantly decreased from 1.03±0.74 to 0.83±0.73 (P<0.001),but height SDS for BA(HtSDSBA) increased from (-0.56±0.78) to (-0.26±0.65) (P<0.001).There was no significant change in serum IGF-I SDS,IGFBP-3 SDS,and IGF-I/IGFBP-3 ratio(P>0.05).The advanced BA was the factor most strongly correlated to the height velocity (R=0.291,P<0.05). Conclusions There is no significant change in serum IGF-I SDS,IGFBP-3 SDS,and IGF-I/IGFBP-3 ratio after GnRHa treatment.The height velocity affected by GnRHa treatment may due to other mechanism than suppression of the IGF-I secretory axis.

Key words: central precocious puberty, gonadotropin-releasing hormone analogues, somatotropin axis, growth velocity

摘要： 目的 探讨促性腺激素释放激素类似物(GnRHa)治疗女童特发性中枢性性早熟(ICPP)对促生长素轴功能与生长速度关系的影响,为GnRHa治疗后出现的生长减速寻找新的治疗方法提供理论依据。方法 对接受GnRHa治疗的27例ICPP女童,观察在治疗开始以及治疗1年后其身高、骨龄、血清胰岛素样生长因子I(insulin-like growth factor-1,IGF-I)以及胰岛素生长因子结合蛋白3(IGFBP-3)等数据。依据她们的年龄分别计算身高、骨龄、IGF-I以及IGFBP3的标准差积分(SDS)。结果 ICPP患儿GnRHa治疗1年后,按实际年龄的身高SDS从1.03±0.74下降至0.83±0.73(P<0.001),按骨龄的身高SDS从-0.56±0.78增至-0.26±0.65(P<0.001)。治疗前后IGF-I SDS,IGFBP-3 SDS以及IGF-I/IGFBP-3差异无统计学意义(P>0.05)。与身高生长速度相关性最强的是提前的骨龄(R=0.291,P<0.05)。结论 ICPP患儿GnRHa治疗前后IGF-I、IGFBP-3均无明显改变,GnRHa可能是通过抑制IGF-I分泌轴之外的机制来影响身高生长速度。

关键词: 中枢性性早熟, 促性腺激素释放激素类似物, 促生长素轴, 生长速度