Effects Of GnRH-a On Serum IGF-1,IGFBP-3 Levels And Bone Age In Girls With Idiopathic Precocious Puberty

Purpose:To investigate the effects of gonadotropin releasing hormone agonist(GnRH-a)on serum insulin-like growth factor-1(IGF-1),insulin-like growth factor binding protein-3(IGFBP-3)and bone age in girls with idiopathic central precocious puberty(ICPP),and to explore the effects of GnRH-a on IGF-1,IGFBP-3 and bone age.Methology:The clinical data of 35 ICPP girls(ICPP group)who were diagnosed and treated with GnRH-a for one year in our hospital from September 2017 to December 2019 and 30 normal developmental prepubertal girls of the same age who came to the outpatient clinic for physical examination in our hospital(control group)were analyzed retrospectively.The serum levels of IGF-1 and IGFBP-3 were compared between the ICPP group and the control group before treatment.At the same time,the changes of bone age,bone age difference(BAD),bone age index(BAI),volume of uterine,volume of ovarian,LH peak,FSH peak,serum IGF-1,serum IGFBP-3,age-based IGF-1 standard deviation score(CA-IGF-1 SDS)and age-based IGFBP-3standard deviation score(CA-IGFBP-3 SDS)in ICPP group were compared before treatment,6 months and 12 months after treatment.Results:The levels of serum IGF-1 and IGFBP-3 in ICPP group were significantly higher than those in control group(P<0.05).After 6 and 12 months of GnRH-a treatment,the uterine volume,ovarian volume,peak value of LH and peak value of FSH in ICPP group were significantly lower than those before treatment(P < 0.05);BAD and BAI showed a downward trend,and the difference was significant after 12 months of treatment(P<0.05);The serum levels of IGF-1 and IGFBP-3 showed an upward trend,while the levels of CA-IGF-1 SDS and CA-IGFBP-3 SDS showed a downward trend,but there was no significant difference between the two groups(P> 0.05).In ICPP group,the levels of serum IGF-1,IGFBP-3 and CA-IGF-1 SDS and CA-IGFBP-3 SDS were positively correlated with BAD,BAI,uterine volume andovarian volume before treatment.During the treatment the level of serum IGFBP-3was positively correlated with the level of IGF-1.Conclusions:GnRH-a is effective in treating girls with idiopathic central precocious puberty,which can inhibit the axis of gland,reduce the volume of uterus and ovary and inhibit the progression of bone age.The effect of hypothalamo-pituitary-gonadal axis on serum IGF-1 and IGFBP-3 is irreversible.GnRH-a may cause linear growth disorder through ways other than GH-IGF-1 axis.