The efficacy and safety of gonadotropin-releasing hormone analog treatment in childhood and adolescence: a single center, long-term follow-up study.
OBJECTIVE
The objective of the study was to evaluate the long-term effect of GnRH analog (GnRHa) treatment on final height (FH), body mass index (BMI), body composition, bone mineral density (BMD), and ovarian function.


METHODS
Ninety-two females, evaluated in adulthood, were categorized as follows: group A, 47 girls with idiopathic central precocious puberty (33 GnRHa treated and 14 nontreated); group B, 24 girls with isolated GH deficiency (15 GnRHa and GH treated and nine GH treated); group C, 21 girls with idiopathic short stature (seven GnRHa and GH treated, seven GnRHa treated, and seven nontreated).


RESULTS
FH, BMD, and percent fat mass of GnRHa-treated patients in all three groups were comparable with those of the respective nontreated subjects. BMI values of GnRHa-treated and nontreated subjects in groups A and C were comparable, whereas in group B, a higher BMI was found in subjects treated only with GH. Nontreated patients with ICPP had greater maximal ovarian volumes, higher LH and LH to FSH ratio, and more severe hirsutism than GnRHa-treated ones. Menstrual cycle characteristics were not different between treated and nontreated subjects. The prevalence of polycystic ovary syndrome in treated and untreated girls with ICPP was comparable, whereas in the entire cohort, it was 11.1% in GnRHa treated and 32.1% in the untreated (P = 0.02).


CONCLUSIONS
Girls treated in childhood with GnRHa have normal BMI, BMD, body composition, and ovarian function in early adulthood. FH is not increased in girls with ICPP in whom GnRHa was initiated at about 8 yr. There is no evidence that GnRHa treatment predisposes to polycystic ovary syndrome or menstrual irregularities.
Magiakou
Maria Alexandra
MA
Division of Endocrinology, Athens University Medical School, Aghia Sophia Children's Hospital, 11527 Athens, Greece. mmayakou@med.uoa.gr
Manousaki
Despoina
D
Papadaki
Marina
M
Hadjidakis
Dimitrios
D
Levidou
Georgia
G
Vakaki
Marina
M
Papaefstathiou
Athanassios
A
Lalioti
Niki
N
Kanaka-Gantenbein
Christina
C
Piaditis
George
G
Chrousos
George P
GP
Dacou-Voutetakis
Catherine
C
D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006130:Growth Disorders / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000172:deficiency; D006801:Humans; D008186:Luteolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011629:Puberty, Precocious / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D055815:Young Adult
D004338:Drug Combinations; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D019382:Human Growth Hormone; D007987:Gonadotropin-Releasing Hormone