Bone mineral density and body composition before and during treatment with gonadotropin-releasing hormone agonist in children with central precocious and early puberty

被引:72
作者
Boot, AM
Keizer-Schrama, SMPFD
Pols, HAP
Krenning, EP
Drop, SLS
机构
[1] Sophia Childrens Univ Hosp, Div Endocrinol, Dept Pediat, NL-3015 GJ Rotterdam, Netherlands
[2] Erasmus Univ, Dept Nucl Med, Hosp Dijkzigt, NL-3015 GJ Rotterdam, Netherlands
[3] Erasmus Univ, Dept Internal Med, Hosp Dijkzigt, NL-3015 GJ Rotterdam, Netherlands
关键词
D O I
10.1210/jc.83.2.370
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Major changes in bone mineral density (BMD) and body composition occur during puberty. In the present longitudinal study, we evaluated BMD and calculated volumetric BMD [bone mineral apparent density (BMAD)], bone metabolism, and body composition of children (32 girls and 2 boys) with central precocious and early puberty before and during treatment with GnRH agonist (GnRH). Patients were studied at baseline and during treatment for 6 months (n = 34), 1 yr (n = 33), and 2 yr (n = 16). Lumbar spine and total body BMD and body composition were measured with dual-energy x-ray absorptiometry. The variables were compared with age-and sex-matched reference values of the same population and expressed as SD score (SDS). Bone age was assessed. Serum calcium, phosphate, alkaline phosphatase, osteocalcin, the carboxyterminal propeptide of type I collagen (PICP), cross-linked telopeptide of collagen I (ICTP), 1,25 dihydroxyvitamin D and urinary hydroxyproline/creatinine, and calcium/creatinine ratios were measured. Mean lumbar spine BMD SDS was significantly higher than zero at baseline (P < 0.02) and did not differ from normal, after 2 yr of treatment. Mean spinal BMAD SDS and total body BMD SDS were not significantly different from zero at baseline and had not changed significantly after 2 yr of treatment. During therapy, fat mass and percentage body fat SDS increased, whereas lean tissue mass SDS decreased. Mean lumbar spine BMD and BMAD and total body BMD SDS, calculated for bone age, were all lower than zero at baseline (BMD P < 0.001 and BMAD P < 0.05) and also after 2 yr treatment (respectively, P < 0.001, P < 0.05, and P < 0.01). Biochemical bone parameters were significantly higher than prepubertal values at baseline, and they decreased during treatment. In conclusion, patients with central precocious and early puberty had normal BMD for chronological age but low BMD for bone age, after 2 yr of treatment with GnRH. Bone turnover decreased during treatment. Changes in body composition resembled those seen in patients with GH deficiency.
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收藏
页码:370 / 373
页数:4
相关论文
共 36 条
[1]   ANALYSIS OF 24-HOUR GROWTH-HORMONE PROFILES IN HEALTHY BOYS AND GIRLS OF NORMAL STATURE - RELATION TO PUBERTY [J].
ALBERTSSONWIKLAND, K ;
ROSBERG, S ;
KARLBERG, J ;
GROTH, T .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1994, 78 (05) :1195-1201
[2]   BODY-COMPOSITION, BONE METABOLISM, AND HEART STRUCTURE AND FUNCTION IN GROWTH-HORMONE (GH)DEFICIENT ADULTS BEFORE AND AFTER GH REPLACEMENT THERAPY AT LOW-DOSES [J].
AMATO, G ;
CARELLA, C ;
FAZIO, S ;
LAMONTAGNA, G ;
CITTADINI, A ;
SABATINI, D ;
MARCIANOMONE, C ;
SACCA, L ;
BELLASTELLA, A .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1993, 77 (06) :1671-1676
[3]  
[Anonymous], [No title captured]
[4]   BONE-MINERAL METABOLISM IN GIRLS WITH PRECOCIOUS PUBERTY DURING GONADOTROPIN-RELEASING-HORMONE AGONIST TREATMENT [J].
ANTONIAZZI, F ;
BERTOLDO, F ;
ZAMBONI, G ;
VALENTINI, R ;
SIRPRESI, S ;
CAVALLO, L ;
ADAMI, S ;
TATO, L .
EUROPEAN JOURNAL OF ENDOCRINOLOGY, 1995, 133 (04) :412-417
[5]   THE EFFECT OF GROWTH-HORMONE ADMINISTRATION IN GROWTH-HORMONE DEFICIENT ADULTS ON BONE, PROTEIN, CARBOHYDRATE AND LIPID HOMEOSTASIS, AS WELL AS ON BODY-COMPOSITION [J].
BINNERTS, A ;
SWART, GR ;
WILSON, JHP ;
HOOGERBRUGGE, N ;
POLS, HAP ;
BIRKENHAGER, JC ;
LAMBERTS, SWJ .
CLINICAL ENDOCRINOLOGY, 1992, 37 (01) :79-87
[6]  
BLUHMSOHN A, 1994, CLIN ENDOCRINOL OXF, V40, P663
[7]   CRITICAL YEARS AND STAGES OF PUBERTY FOR SPINAL AND FEMORAL BONE MASS ACCUMULATION DURING ADOLESCENCE [J].
BONJOUR, JP ;
THEINTZ, G ;
BUCHS, B ;
SLOSMAN, D ;
RIZZOLI, R .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1991, 73 (03) :555-563
[8]   Changes in bone mineral density, body composition, and lipid metabolism during growth hormone (GH) treatment in children with GH deficiency [J].
Boot, AM ;
Engels, MAMJ ;
Boerma, GJM ;
Krenning, EP ;
KeizerSchrama, SMPFD .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1997, 82 (08) :2423-2428
[9]   Bone mineral density in children and adolescents: Relation to puberty, calcium intake, and physical activity [J].
Boot, AM ;
deRidder, MAJ ;
Pols, HAP ;
Krenning, EP ;
KeizerSchrama, SMPFD .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1997, 82 (01) :57-62
[10]   Determinants of body composition measured by dual-energy X-ray absorptiometry in Dutch children and adolescents [J].
Boot, AM ;
Bouquet, J ;
deRidder, MAJ ;
Krenning, EP ;
KeizerSchrama, SMPFD .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 1997, 66 (02) :232-238