Abstract
Objective — to study the effect of analogues of gonadotropin-releasing hormone (aGRH) in combination with recombinant growth hormone (rGH) on the terminal growth of children with the syndrome of bioinactive growth hormone (GH) during puberty. Materials and methods. The study included 46 children with bioinactive GH and the onset of sexual development at the age from 10 to 12 years, who were divided into 2 groups. Group 1 consisted of 21 patients who received rGH in combination with aGRH. The comparison group (group 2) consisted of 25 children, which were used only rGH. The criterion for the prescription of aGRH therapy was the confirmation of rapid progress of the sexual development with an unsatisfactory growth prognosis. To inhibit the sexual development, an analogue of luliberin — tryptoreline was used. Results and discussion. At the beginning of treatment, the standard deviation (SD) in patients of group 1 was (–2.6 ± 0.6) SD, while in group 2 it was (–2.4 ± 0.7) SD. Against the background of treatment in group 1, SD scores differed significantly from baseline in boys and girls, (p < 0.01 and p < 0.05 respectively), as opposed to SD in group 2, which had no significant differences with baseline values before treatment. The difference in growth between terminal and expected growth (EG) among patients of group 1 in boys was (15.02 ± 0.9) cm, and in girls — (14.55 ± 1.1) cm, which is significantly higher than in patients of group 2 (p < 0.01), where the corresponding difference was (10.32 ± 0.9) cm for boys and (8.2 ± 1.2) cm for girls. Patients who used rGH in combination with aGRH had significantly better terminal growth in comparison with expected growth, in contrast to children taking only rGH. Conclusions. The use of aGRH in combination with rGH is an effective and safe treatmentof patients with the syndrome of bioinactive GH with early onset puberty, which significantly improves the terminal growth of patients regardless of gender, as compared to rGH monotherapy. After withdrawal of aGRHa complete restoration of sexual function occurs.
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