促性腺激素释放激素类似物治疗对中枢性性早熟和快速进展型青春期患儿成年终身高改善的Meta分析

储昭乐, 江辉, 吴倩

中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (11) : 1161-1168.

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中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (11) : 1161-1168. DOI: 10.7499/j.issn.1008-8830.2108078
论著·临床研究

促性腺激素释放激素类似物治疗对中枢性性早熟和快速进展型青春期患儿成年终身高改善的Meta分析

  • 储昭乐, 江辉, 吴倩
作者信息 +

Effect of gonadotropin-releasing hormone analogue treatment in improving final adult height of children with central precocious puberty or early and fast puberty: a Meta analysis

  • CHU Zhao-Le, JIANG Hui, WU Qian
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文章历史 +

摘要

目的 系统评价促性腺激素释放激素类似物(gonadotropin-releasing hormone analogue,GnRHa)治疗6岁以上中枢性性早熟(central precocious puberty,CPP)和快速进展型青春期(early and fast puberty,EFP)患儿的疗效。 方法 检索PubMed、MEDLINE、Embase、Cochrane Library、中国知网和万方数据库,收集GnRHa治疗CPP和EFP患儿的相关文献,应用Stata 12.0软件对文献资料进行Meta分析。 结果 共纳入10篇文献。总样本量为720例,其中GnRHa治疗组475例,对照组245例。Meta分析结果显示GnRHa治疗组成年终身高[加权均数差(weighted mean difference,WMD)=3.30,95%CI:2.49~4.12,P<0.001]、成年终身高标准差积分(WMD=0.51,95%CI:0.29~0.73,P<0.001)、身高获益(WMD=2.89,95%CI:2.17~3.60,P<0.001)均优于对照组。所有的研究均无严重不良事件报道。 结论 GnRHa治疗对于改善6岁以上CPP和EFP患儿的成年终身高安全有效。 引用格式:

Abstract

Objective To systematically evaluate the effect of gonadotropin-releasing hormone analogue (GnRHa) treatment on the final adult height of children over 6 years of age with central precocious puberty (CPP) or early and fast puberty (EFP). Methods PubMed, MEDLINE, Embase, Cochrane Library, CNKI, and Wanfang Data were searched for related articles on GnRHa treatment for children with CPP or EFP. Stata 12.0 software was used to perform a Meta analysis of related data. Results A total of 10 studies were included, and the total sample size was 720 children, with 475 children in the GnRHa treatment group and 245 children in the control group. The Meta analysis showed that compared with the control group, the GnRHa treatment group had significantly better final adult height (WMD=3.30, 95%CI: 2.49-4.12, P<0.001), standard deviation score of final adult height (WMD=0.51, 95%CI: 0.29-0.73, P<0.001), and height gain (WMD=2.89, 95%CI: 2.17-3.60, P<0.001). No severe adverse events were reported in these studies. Conclusions GnRHa treatment is safe and effective in improving the final adult height of children over 6 years of age with CPP or EFP. Citation:

关键词

中枢性性早熟 / 快速进展型青春期 / 促性腺激素释放激素类似物 / 成年终身高 / Meta分析 / 儿童

Key words

Central precocious puberty / Early and fast puberty / Gonadotropin-releasing hormone analogue / Final adult height / Meta analysis / Child

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储昭乐, 江辉, 吴倩. 促性腺激素释放激素类似物治疗对中枢性性早熟和快速进展型青春期患儿成年终身高改善的Meta分析[J]. 中国当代儿科杂志. 2021, 23(11): 1161-1168 https://doi.org/10.7499/j.issn.1008-8830.2108078
CHU Zhao-Le, JIANG Hui, WU Qian. Effect of gonadotropin-releasing hormone analogue treatment in improving final adult height of children with central precocious puberty or early and fast puberty: a Meta analysis[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(11): 1161-1168 https://doi.org/10.7499/j.issn.1008-8830.2108078

参考文献

1 中华医学会儿科学分会内分泌遗传代谢学组, 《中华儿科杂志》编辑委员会. 中枢性性早熟诊断与治疗共识(2015)[J]. 中华儿科杂志, 2015, 53(6): 412-418. PMID: 26310550. DOI: 10.3760/cma.j.issn.0578-1310.2015.06.004.
2 Partsch CJ, Heger S, Sippell WG. Treatment of central precocious puberty: lessons from a 15 years prospective trial. German Decapeptyl Study Group[J]. J Pediatr Endocrinol Metab, 2000, 13(Suppl 1): 747-758. PMID: 10969917. DOI: 10.1515/jpem.2000.13.s1.747.
3 Kletter GB, Kelch RP. Clinical review 60: effects of gonadotropin-releasing hormone analog therapy on adult stature in precocious puberty[J]. J Clin Endocrinol Metab, 1994, 79(2): 331-334. PMID: 8045943. DOI: 10.1210/jcem.79.2.8045943.
4 Lazar L, Meyerovitch J, de Vries L, et al. Treated and untreated women with idiopathic precocious puberty: long-term follow-up and reproductive outcome between the third and fifth decades[J]. Clin Endocrinol (Oxf), 2014, 80(4): 570-576. PMID: 24033561. DOI: 10.1111/cen.12319.
5 Faienza MF, Brunetti G, Acquafredda A, et al. Metabolic outcomes, bone health, and risk of polycystic ovary syndrome in girls with idiopathic central precocious puberty treated with gonadotropin-releasing hormone analogues[J]. Horm Res Paediatr, 2017, 87(3): 162-169. PMID: 28391271. DOI: 10.1159/000456546.
6 Kauli R, Galatzer A, Kornreich L, et al. Final height of girls with central precocious puberty, untreated versus treated with cyproterone acetate or GnRH analogue. A comparative study with re-evaluation of predictions by the bayley-pinneaumethod[J]. Horm Res, 1997, 47(2): 54-61. PMID: 9030968. DOI: 10.1159/000185432.
7 Lazar L, Lebenthal Y, Yackobovitch-Gavan M, et al. Treated and untreated women with idiopathic precocious puberty: BMI evolution, metabolic outcome, and general health between third and fifth decades[J]. J Clin Endocrinol Metab, 2015, 100(4): 1445-1451. PMID: 25650898. DOI: 10.1210/jc.2014-3748.
8 Poomthavorn P, Suphasit R, Mahachoklertwattana P. Adult height, body mass index and time of menarche of girls with idiopathic central precocious puberty after gonadotropin-releasing hormone analogue treatment[J]. Gynecol Endocrinol, 2011, 27(8): 524-528. PMID: 21501002. DOI: 10.3109/09513590.2010.507289.
9 Stasiowska B, Vannelli S, Benso L. Final height in sexually precocious girls after therapy with an intranasal analogue of gonadotrophin-releasing hormone (buserelin)[J]. Horm Res, 1994, 42(3): 81-85. PMID: 7995616. DOI: 10.1159/000184152.
10 Swaiss HH, Khawaja NM, Farahid OH, et al. Effect of gonadotropin-releasing hormone analogue on final adult height among Jordanian children with precocious puberty[J]. Saudi Med J, 2017, 38(11): 1101-1107. PMID: 29114697. PMCID: PMC5767612. DOI: 10.15537/smj.2017.11.21187.
11 Pasquino AM, Pucarelli I, Accardo F, et al. Long-term observation of 87 girls with idiopathic central precocious puberty treated with gonadotropin-releasing hormone analogs: impact on adult height, body mass index, bone mineral content, and reproductive function[J]. J Clin Endocrinol Metab, 2008, 93(1): 190-195. PMID: 17940112. DOI: 10.1210/jc.2007-1216.
12 Bouvattier C, Coste J, Rodrigue D, et al. Lack of effect of GnRH agonists on final height in girls with advanced puberty: a randomized long-term pilot study[J]. J Clin Endocrinol Metab, 1999, 84(10): 3575-3578. PMID: 10522998. DOI: 10.1210/jcem.84.10.6032.
13 Chiavaroli V, Liberati M, D'Antonio F, et al. GNRH analog therapy in girls with early puberty is associated with the achievement of predicted final height but also with increased risk of polycystic ovary syndrome[J]. Eur J Endocrinol, 2010, 163(1): 55-62. PMID: 20356934. DOI: 10.1530/EJE-09-1102.
14 Sava?-Erdeve ?, ??klar Z, Hac?hamdio?lu B, et al. Gonadotropin-releasing hormone analogue treatment in females with moderately early puberty: no effect on final height[J]. J Clin Res Pediatr Endocrinol, 2016, 8(2): 211-217. PMID: 26758571. PMCID: PMC5096478. DOI: 10.4274/jcrpe.2356.
15 Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions: version 5.1.0[EB/OL]. (2011-03) [2021-08-16]. https://training.cochrane.org/handbook/archive/v5.1/.
16 张天嵩. 经典Meta分析统计模型的合理选择[J]. 中国循证医学杂志, 2020, 20(12): 1477-1481. DOI: 10.7507/1672-2531.202008152.
17 S?rensen K, Mouritsen A, Aksglaede L, et al. Recent secular trends in pubertal timing: implications for evaluation and diagnosis of precocious puberty[J]. Horm Res Paediatr, 2012, 77(3): 137-145. PMID: 22508036. DOI: 10.1159/000336325.
18 Carel JC, Eugster EA, Rogol A, et al. Consensus statement on the use of gonadotropin-releasing hormone analogs in children[J]. Pediatrics, 2009, 123(4): e752-e762. PMID: 19332438. DOI: 10.1542/peds.2008-1783.
19 Bangalore Krishna K, Fuqua JS, Rogol AD, et al. Use of gonadotropin-releasing hormone analogs in children: update by an international consortium[J]. Horm Res Paediatr, 2019, 91(6): 357-372. PMID: 31319416. DOI: 10.1159/000501336.
20 Luo XP, Liang Y, Hou L, et al. Long-term efficacy and safety of gonadotropin-releasing hormone analog treatment in children with idiopathic central precocious puberty: a systematic review and meta-analysis[J]. Clin Endocrinol (Oxf), 2021, 94(5): 786-796. PMID: 33387371. PMCID: PMC8248422. DOI: 10.1111/cen.14410.
21 Franzini IA, Yamamoto FM, Bolfi F, et al. GnRH analog is ineffective in increasing adult height in girls with puberty onset after 7 years of age: a systematic review and meta-analysis[J]. Eur J Endocrinol, 2018, 179(6): 381-390. PMID: 30324797. DOI: 10.1530/EJE-18-0473.
22 Fu JF, Zhang JW, Chen RM, et al. Long-term outcomes of treatments for central precocious puberty or early and fast puberty in Chinese girls[J]. J Clin Endocrinol Metab, 2020, 105(3): dgz027. PMID: 31702013. DOI: 10.1210/clinem/dgz027.
23 Liu S, Liu Q, Cheng X, et al. Effects and safety of combination therapy with gonadotropin-releasing hormone analogue and growth hormone in girls with idiopathic central precocious puberty: a meta-analysis[J]. J Endocrinol Invest, 2016, 39(10): 1167-1178. PMID: 27225286. DOI: 10.1007/s40618-016-0486-9.
24 Wojniusz S, Callens N, Sütterlin S, et al. Cognitive, emotional, and psychosocial functioning of girls treated with pharmacological puberty blockage for idiopathic central precocious puberty[J]. Front Psychol, 2016, 7: 1053. PMID: 27462292. PMCID: PMC4940404. DOI: 10.3389/fpsyg.2016.01053.
25 Schoelwer MJ, Donahue KL, Didrick P, et al. One-year follow-up of girls with precocious puberty and their mothers: do psychological assessments change over time or with treatment?[J]. Horm Res Paediatr, 2017, 88(5): 347-353. PMID: 28926827. PMCID: PMC5808430. DOI: 10.1159/000479688.

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