Santral erken puberte tanılı çocuklarda GnRH agonist tedavisinin vücut kitle indeksi üzerine etkisi
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Dosyalar
Tarih
2020
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Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
maç: Santral erken pubertenin (SEP) tedavisinde uzun yıllardır gonadotropin salgılatıcı hormon (GnRH) agonistleri kullanılmaktadır. Yan etkileri arasında vücut ağırlığında ve vücut kitle indeksinde (VKİ) artış görülmüştür ancak literatür incelendiğinde bununla ilgili yapılan çalışmalarda farklı sonuçlar elde edilmiştir. Biz de çalışmamızda SEP tanısı ile GnRH agonisti kullanmış olgularımızın tedavi süresince ve finalde VKİ standart deviasyon skoru (SDS) değişimlerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Ege Üniversitesi Çocuk Endokrinoloji ve Diyabet Bilim Dalı'nda Ocak 2004 ile Aralık 2014 tarihleri arasında idiyopatik SEP tanısı alarak GnRH agonist tedavisi kullanan 92 kız hasta çalışmaya dahil edildi. Olguların poliklinik dosyaları retrospektif olarak incelendi. Demografik verileri, izlem süresince belirli aralıkla yapılan antropometrik ölçümleri, tedavi dozları, görüntülemeleri elde edildi. Bulgular: Çalışmaya alınan 92 kız hastanın 58'i normal kilolu, 31'i fazla kilolu ve 3'ü obezdi. Hastalar normal kilolu grup ile fazla kilolu ve obez grup olarak ikiye ayrıldı. Her iki grubun demografik özellikleri ve tedavi süreleri benzerdi. Tüm hastaların tedavilerinin 1. yılında VKİ SDS değerinde anlamlı artış (p=0.014) olmasına rağmen tanı ve tedavi sonundaki değerler karşılaştırıldığında anlamlı farklılık saptanmadı (p=0.68). Normal kilolu grubun tanı ve tedavinin 1. yılı VKİ SDS değeri arasında istatistiksel olarak anlamlı artış olduğu (p=0.004) görüldü ancak tanı ile final VKİ SDS'leri karşılaştırıldığında değerler benzerdi (p=0.15). Fazla kilolu ve obez grubun VKİ SDS değerinin tedavi süresinde değişimi anlamlı bulunmadı (p=0.46). Hastaların izlem süresince boy SDS değerlerinde azalma (p<0.01) gözlenirken tahmini erişkin boylarında artış elde edildi (p=0.005).Kemik Yaşı (KY)/Takvim Yaşı(TY) oranının izlem yıllarında istatistiksel anlamlı azaldığı saptandı (p=0.13). Sonuç: Çalışmada SEP tanılı kızlarda GnRH agonist tedavisinin VKİ ve VKİ SDS arttrıcı etkisi görülmedi. Tedavi ile KY ilerlemesinin önüne geçilerek tahmini erişkin boyda artış sağlandı.
Aim: GnRH agonists have been used for many years in the treatment of central precocious puberty. Although its side effects include increase in body weight and body mass index (BMI), different results have been obtained when studies related in the literature are examined. In our study, we aimed to evaluate the changes of BMI SDS during the treatment and in the final of our patients who used GnRH agonists with the diagnosis of CPB. Material and Methods: 92 patients who were diagnosed with idiopathic CPB between January 2004 and December 2014 at Ege University, Department of Pediatric Endocrinology and Diabetes were included in the study. The files of the cases were analyzed retrospectively. Demographic data, anthropometric measurements, treatment doses, and imaging performed at certain intervals during the follow-up were obtained. Results: From the 92 patients included in the study, 58 of them were in normal weight, 31 of them were overweight and 3 were obese. The patients were splitted into two groups as normal weight group and overweight and obese group. The demographic characteristics and duration of treatment of both groups were similar. Although there was a significant increase in BMI SDS value in the first year of the treatment of all patients (p=0.014), no significant difference was found when the values at diagnosis and the end of treatment (p=0.68). There was a statistically significant increase between BMI SDS value of the first year of diagnosis and treatment in the normal weight group (p=0.004), but the values were similar when the diagnosis and final BMB SDS values were compared (p=0.15). The change in BMS SDS value in the treatment period of overweight and obese group was not significant (p=0.46). During the follow-up period, decrease in height SDS values (p=0.01) was observed, while an increase in estimated adult height was obtained (p = 0.005). CA/BA was found to decrease statistically significantly in the follow-up years (p = 0.13). Conclusion: In the study, BMI and BMI SDS enhancing effects of GnRH agonist treatment were not observed in the girls with CPB. With the treatment, the progression of BA was prevented and increase in estimated adult height was achieved.
Aim: GnRH agonists have been used for many years in the treatment of central precocious puberty. Although its side effects include increase in body weight and body mass index (BMI), different results have been obtained when studies related in the literature are examined. In our study, we aimed to evaluate the changes of BMI SDS during the treatment and in the final of our patients who used GnRH agonists with the diagnosis of CPB. Material and Methods: 92 patients who were diagnosed with idiopathic CPB between January 2004 and December 2014 at Ege University, Department of Pediatric Endocrinology and Diabetes were included in the study. The files of the cases were analyzed retrospectively. Demographic data, anthropometric measurements, treatment doses, and imaging performed at certain intervals during the follow-up were obtained. Results: From the 92 patients included in the study, 58 of them were in normal weight, 31 of them were overweight and 3 were obese. The patients were splitted into two groups as normal weight group and overweight and obese group. The demographic characteristics and duration of treatment of both groups were similar. Although there was a significant increase in BMI SDS value in the first year of the treatment of all patients (p=0.014), no significant difference was found when the values at diagnosis and the end of treatment (p=0.68). There was a statistically significant increase between BMI SDS value of the first year of diagnosis and treatment in the normal weight group (p=0.004), but the values were similar when the diagnosis and final BMB SDS values were compared (p=0.15). The change in BMS SDS value in the treatment period of overweight and obese group was not significant (p=0.46). During the follow-up period, decrease in height SDS values (p=0.01) was observed, while an increase in estimated adult height was obtained (p = 0.005). CA/BA was found to decrease statistically significantly in the follow-up years (p = 0.13). Conclusion: In the study, BMI and BMI SDS enhancing effects of GnRH agonist treatment were not observed in the girls with CPB. With the treatment, the progression of BA was prevented and increase in estimated adult height was achieved.
Açıklama
Anahtar Kelimeler
Erken Puberte, Tedavi, GnRH Agonist, VKİ, Precocious Puberty, Treatment, GnRH Agonist
