Korean Journal of Pediatrics 2007;50(7):678-685.
Published online July 15, 2007.
Growth promoting effect of combined gonadotropin releasing hormone analogue and growth hormone therapy in early pubertal girls with predicted low adult heights
Eun-Jeong Hong, Heon-Seok Han
Department of Pediatrics, College of Medicine and Medical Research Institute Chungbuk National University, Cheongju, Korea
예측성인신장이 작은 조기사춘기 여아에서 성선자극호르몬 방출호르몬 효능약제와 성장호르몬 병합치료의 성장획득 효과
홍은정, 한헌석
충북대학교 의과대학 소아과학교실
Correspondence: 
Heon-Seok Han, Email: hshan@chungbuk.ac.kr
Abstract
Purpose
: Recent reports pointed out that gonadotropin releasing hormone analogue (GnRHa) therapy alone is not so promising for improving adult height in precocious puberty. So, that we studied the growth promoting effect of combined therapy with GnRHa and growth hormone (GH) in early pubertal girls.
Methods
: Twenty three early pubertal girls (9.73?.59 yr) with predicted adult heights (PAH) below -2 standard deviation score (SDS) were included. They were divided into two groups as follows; Group I before menarche (n=19) and Group II after menarche (n=4). After combined therapy, various growth parameters were compared between two groups and between the before and after therapy.
Results
: Between the two groups before therapy, chronologic age (CA), growth velocity (GV), body mass index (BMI), target height (TH), PAH and serum insulin-like growth factor binding protein-3 were not different, but BA, height and difference between bone age (BA) and CA were significantly higher and insulin-like growth factor-1 (IGF-1) was marginally higher in group II. After therapy, BA still remained higher in group II, but other parameters were not different. In both groups, after therapy, the difference between BA and CA, the ratio of BA over CA, and GV were significantly decreased, but PAH, height SDS and BMI were significantly increased. Regarding IGF-1 level, a significant increase was noted in group I, but not in group II.
Conclusion
: With combined therapy of GnRHa and GH, PAH in early pubertal girls might be improved significantly and even approach TH. Among them, those who were before menarche might have greater potential for the height gain than those after menarche in view of IGF-1 changes during therapy.
Key Words: Gonadotropin releasing hormone, Growth hormone, Precocious puberty


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