Overnight Levels of Luteinizing Hormone, Follicle-Stimulating Hormone and Growth Hormone before and during Gonadotropin-Releasing Hormone Analogue Treatment in Short Boys Born Small for Gestational Age

Abstract

Aims: To evaluate if 3 months of gonadotropin-releasing hormone analogue (GnRHa) treatment results in sufficient suppression of pubertal luteinizing hormone (LH) and follicle-stimulating hormone (FSH) profile patterns in short pubertal small for gestational age (SGA) boys. To compare growth hormone (GH) profiles and fasting insulin-like growth factor (IGF)-I and IGF-binding protein-3 (IGFBP-3) levels after 3 months of GnRHa treatment with those at baseline. Methods: After measurement of baseline overnight profiles and IGF-I and IGFBP-3 levels, 14 short pubertal SGA boys received leuprorelide acetate depots of 3.75 mg subcutaneously, every 4 weeks. Results: At baseline, mean GH levels were comparable with those of controls, whereas IGF-I and IGFBP-3 standard deviation scores (SDS) were significantly lower than zero SDS. After 3 months of GnRHa treatment, all boys showed clinical arrest of puberty. The area under the curve above zero, mean and maximum LH and FSH had significantly decreased to prepubertal levels. Peak LH during the GnRH agonist test, however, indicated insufficient pubertal suppression in 43% of boys. Overnight GH profile characteristics and IGF-I and IGFBP-3 levels did not significantly change. Conclusions: Puberty was sufficiently suppressed by GnRHa treatment, as shown by the prepubertal LH and FSH profiles. After 3 months of GnRHa treatment, overnight GH profile characteristics had not significantly changed, reflecting that GH levels are comparable for prepubertal and early pubertal boys.

Randomized GH trial with two different dosages in combination with a GnRH analogue in short small for gestational age children: effects on metabolic profile and serum GH, IGF1, and IGFBP3 levels

“…Table 1 lists the clinical data. At the start of GH treatment, all children had clinical suppression of puberty and prepubertal overnight LH and FSH profile patterns as we reported previously (25,26). No significant differences were found between groups A and B or between boys and girls.…”

Bone Mineral Density and Body Composition in Short Children Born SGA during Growth Hormone and Gonadotropin Releasing Hormone Analog Treatment

“…Children with a height less than 140 cm at the start of puberty were defined as children with an expected AH less than Ϫ2.5 SDS and received GnRHa (leuprorelide acetate depots 3.75 mg sc every 4 wk) for 2 yr in addition to GH treatment. During GnRHa treatment, puberty was clinically fully suppressed in all children, which was confirmed by GnRHa stimulation tests or overnight gonadotropin profiles (25,26).…”

Reduced levels of GH during GnRH analogue treatment in pubertal short girls born small for gestational age (SGA)

“…At baseline, fat mass was measured by DXA 23 . We previously demonstrated that all girls had clinical arrest of puberty and prepubertal overnight LH profiles, indicating sufficient suppression of central puberty 24,25 …”

“…23 We previously demonstrated that all girls had clinical arrest of puberty and prepubertal overnight LH profiles, indicating sufficient suppression of central puberty. 24,25 Hormone assays GH levels were measured by IMMULITE 2000 (Diagnostic Products Corporation, Los Angeles, CA ) with a lower detection limit of 0·13 mU/l. Values lower than 0·13 mU/l were assigned as 0·13 mU/l.…”