Ann Pediatr Endocrinol Metab.  2014 Dec;19(4):208-213. 10.6065/apem.2014.19.4.208.

Relationship between serum insulin-like growth factor-1, IGF binding protein-3 levels and body height before and after gonadotropin-releasing hormone agonist therapy

• Song HS
• Choi WB
• Song JS
• Hwang IT
• Yang S

• KMID: 1769354
• DOI: http://doi.org/10.6065/apem.2014.19.4.208

Abstract

PURPOSE
The gonadotropin-releasing hormone agonist (GnRHa) is widely used to treat patients with precocious puberty. However, its effect on growth is often difficult to predict because of the diverse nature of its causes and presentation. This study aims to show the impact of GnRHa treatment on insulin-like growth factor-1 (IGF-I) and IGF binding protein-3 (IGFBP-3) secretion, growth, and on other parameters that may help estimate the height velocity.
METHODS
Data from 60 girls (mean age, 8.8+/-0.7 years) treated with GnRHa were analyzed. Their height, bone age (BA), serum IGF-I, and IGFBP-3 concentrations were measured at the start and after a year of GnRHa treatment. To eliminate the confounding effect of chronological age (CA), the standard deviation scores (SDSs) of their height, IGF-I, and IGFBP-3 concentrations according to their CA at the start and after a year of GnRHa treatment were calculated. We looked for possible correlations between these variables and compared the subgroups based on their height velocities and midparental heights.
RESULTS
During their one-year GnRHa therapy, height SDS for CA significantly decreased to 0.81+/-0.83 (P<0.001), but height SDS for BA increased to -0.28+/-0.68 (P<0.001). There was no significant change in serum IGF-I SDS, IGFBP-3 SDS, and IGF-I/IGFBP-3 ratio. The advanced BA was the factor most strongly correlated to the height velocity (R=0.265, P=0.041).
CONCLUSION
These findings suggest that GnRHa treatment may affect the height velocity due to mechanisms other than suppression of the IGF-I and IGFBP-3 secretory axis.

Keyword

Precocious puberty; Insulin-like growth factor I; Body height

MeSH Terms

Axis
Body Height*
Female
Gonadotropin-Releasing Hormone*
Humans
Insulin-Like Growth Factor Binding Protein 3
Insulin-Like Growth Factor I
Puberty, Precocious
Gonadotropin-Releasing Hormone
Insulin-Like Growth Factor Binding Protein 3
Insulin-Like Growth Factor I

Figure

• 

  Fig. 1 Scatter plot of the relationship between the changes in the IGF-I SDS and the height SDS during the GnRHa treatment. IGF-I, insulin-like growth factor I; SDS, standard deviation score; GnRHa, gonadotropin-releasing hormone agonist.

• 

  Fig. 2 Scatter plot of the relationship between the changes in the IGF-I:IGFBP-3 ratio and the height SDS during the gonadotropin-releasing hormone agonist treatment. IGF-I, insulin-like growth factor I; IGFBP-3, insulin-like growth factor binding protein 3; SDS, standard deviation score.

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