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This version published online on November 6, 2009
Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2009-0793
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Submitted on April 13, 2009
Accepted on September 29, 2009

The Efficacy and Safety of Gonadotropin-Releasing Hormone Analog Treatment in Childhood and Adolescence: A Single Center, Long-Term Follow-Up Study

Maria Alexandra Magiakou*, Despoina Manousaki, Marina Papadaki, Dimitrios Hadjidakis, Georgia Levidou, Marina Vakaki, Athanassios Papaefstathiou, Niki Lalioti, Christina Kanaka-Gantenbein, George Piaditis, George P. Chrousos, and Catherine Dacou-Voutetakis

Division of Endocrinology, Metabolism, and Diabetes (M.A.M., D.M., N.L., C.K.-G., G.P.C., C.D.-V.), First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, and Department of Pathology (G.L.), Athens University Medical School, and Department of Radiology (M.P., M.V.), P. and A. Kyriakou Children's Hospital, and Department of Endocrinology and Diabetes Center (G.P.), General Hospital of Athens, 11527 Athens, Greece; and Endocrine Unit (D.H., A.P.), 2nd Department of Internal Medicine-Propaedeutic, Athens University Medical School, Attikon University Hospital, 12462 Athens, Greece

* To whom correspondence should be addressed. E-mail: mmayakou{at}med.uoa.gr.

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.

Subjects/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.






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