Abstract
LHRHa suppresses both gonadotropin pulsations and sex steroids and slows height velocity (HV) in patients with CPP. To evaluate GH's role in this slowing of growth, sleep induced GH secretion (20 min samples, 10 PM – 2 AM) and SOMC (10 PM) were measured in 9 pre-adrenarchal girls with CPP (ages at onset 1.6–6.3 yrs, M=3.8; bone ages advanced a mean of 3.7 yrs). Therapy suppressed gonadotropin pulsations, response to LHRH, estradiol and maturation indices in all patients. Growth velocity fell from 14.4 ± 1.7 cm/yr (Mean ± SEM, all measurements) pretherapy to 8.7 ± 1.4 after 6 mos of therapy (p=0.0005). SOMC levels decreased from 3.1 ± 0.7 IU/ml pretherapy to 1.3 ± 0.2 at 3 mos (p=0.009) and 1.4 ± 0.2 at 6 mos (p=0.007). Nocturnal peak GH levels fell from 25.4 ± 6.8 ng/ml pretreatment to 9.1 ± 1.7 at 3 mos (p < 0.01) and 7.5 ± 1.1 at 6 mos of therapy (p <0.01). Total GH secreted during the 4 hr interval decreased a mean of 58% at 3 mos and 48% at 6 mos compared to pretreatment. The accelerated HV in CPP patients under 6 yrs is associated with increased GH and SOMC production. With LHRHa induced suppresion of gonadal steroids, both HV and GH and SOMC production are decreased.
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