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促性腺激素释放激素激动剂治疗中枢性性早熟对体重指数的影响:系统评价和荟萃分析。

The Effect of GnRHa Treatment on Body Mass Index in Central Precocious Puberty: A Systematic Review and Meta-Analysis.

机构信息

Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Horm Res Paediatr. 2024;97(5):419-432. doi: 10.1159/000535132. Epub 2024 Jan 5.

Abstract

BACKGROUND

Recently, numerous studies have addressed the long-term effects of treatment with gonadotropin-releasing hormone analog (GnRHa) in patients with central precocious puberty (CPP). However, the effects of GnRHa treatment on body mass index (BMI) in patients with CPP remain controversial.

OBJECTIVE

This systematic review and meta-analysis aimed to evaluate the association between GnRHa treatment and BMI in patients with CPP.

METHODS

A systematic search of databases, PubMed, EMBASE, and Web of Science published before August 2021 identified relevant studies. The overall effect analysis was performed using STATA version statistical software 15.0.

RESULTS

The study included a total of 28 studies. At the end of GnRHa treatment, the BMI-standard deviation score (BMI-SDS) was greater than baseline BMI-SDS (weighted mean difference (WMD) = 0.14, 95% CI: 0.04-0.23; p = 0.004), especially in girls with CPP (WMD = 0.15, 95% CI: 0.05-0.25; p = 0.005) and in patients with normal weight (WMD = 0.34, 95% CI: 0.19-0.48, p < 0.001). After reaching adult height, BMI-SDS returned to baseline, suggesting that the effect of GnRHa treatment on BMI would disappear as the child grew (WMD = -0.03, 95% CI: -0.39 to 0.32; p = 0.815).

CONCLUSION

For patients with CPP, while treatment with GnRHa may increase the BMI in the short term after treatment, the BMI is likely to return to normal when the patients reach adult height.

摘要

背景

最近,许多研究都探讨了促性腺激素释放激素类似物(GnRHa)治疗对中枢性性早熟(CPP)患者的长期影响。然而,GnRHa 治疗对 CPP 患者体重指数(BMI)的影响仍存在争议。

目的

本系统评价和荟萃分析旨在评估 GnRHa 治疗与 CPP 患者 BMI 之间的关系。

方法

系统检索了数据库、PubMed、EMBASE 和 Web of Science,检索时间截至 2021 年 8 月,以确定相关研究。使用 STATA 版本 15.0 统计软件进行总体效应分析。

结果

该研究共纳入 28 项研究。在 GnRHa 治疗结束时,BMI 标准差评分(BMI-SDS)高于基线 BMI-SDS(加权均数差(WMD)=0.14,95%CI:0.04-0.23;p=0.004),尤其是 CPP 女孩(WMD=0.15,95%CI:0.05-0.25;p=0.005)和体重正常的患者(WMD=0.34,95%CI:0.19-0.48,p < 0.001)。达到成人身高后,BMI-SDS 恢复到基线,表明 GnRHa 治疗对 BMI 的影响随着儿童的生长而消失(WMD=-0.03,95%CI:-0.39 至 0.32;p=0.815)。

结论

对于 CPP 患者,虽然 GnRHa 治疗在治疗后短期内可能会增加 BMI,但当患者达到成人身高时,BMI 可能会恢复正常。

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