title: Hormonal changes during GnRH analogue therapy in children with central precocious puberty.
abstract: Gonadotropin releasing hormone analogues (GnRHa) have been used for treatment of central precocious puberty (CPP) for more than 15 years. They are generally considered safe although data on potential long-term side effects are scarce. However, GnRHa therapy has profound effects on both the hypothalamopituitary-gonadal axis as well as on growth hormone (GH) secretion. Gonadal activity is increased in children with CPP; during GnRHa therapy secretion of gonadal hormones is suppressed as reflected by measurements of LH, FSH, and estradiol/testosterone. More recently, studies of levels of inhibin A and B as well as markers of androgen action such as SHBG and prostate specific antigen have demonstrated marked suppression of gonadal function possibly to infra-physiological levels. The possible long-term consequences of these observations have yet to be determined. Detailed analyses of the GH-IGF-I axis have revealed a decrease in levels of free, biologically active IGF-I during GnRHa treatment. These findings are in accord with the observed decrease in height velocity in children with CPP under treatment with GnRHa, and may also play a role in the relatively small gain in final height in most patients.
authors.affiliation: Clinic of Growth and Reproduction, The Juliane Marie Centre, The University Hospital, Rigshospitalet, Copenhagen, Denmark. jmuller@rh.dk
authors.forename: J
authors.initials: J
authors.lastname: Müller
authors.forename: A
authors.initials: A
authors.lastname: Juul
authors.forename: A M
authors.initials: AM
authors.lastname: Andersson
authors.forename: A
authors.initials: A
authors.lastname: Sehested
authors.forename: N E
authors.initials: NE
authors.lastname: Skakkebaek
mesh_terms: D000728:Androgens / Q000502:physiology; D001927:Brain Diseases / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006728:Hormones / Q000097:blood*; D019382:Human Growth Hormone / Q000502:physiology; D006801:Humans; D007265:Inhibins / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000502:physiology; D011629:Puberty, Precocious / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology
chemical_list: D000728:Androgens; D006728:Hormones; D019382:Human Growth Hormone; D007987:Gonadotropin-Releasing Hormone; D007265:Inhibins; D007334:Insulin-Like Growth Factor I