Reduction of bone density: An effect of gonadotropin releasing hormone analogue treatment in central precocious puberty
Gonadal steroids drive the significant bone mineral increase that occurs at puberty. Oestrogen deprivation in women results in bone loss. We investigated bone mineralization by single photon absorptiometry in girls with central precocious puberty (n=13, age 3.8–8.5 years) before and during 1 year of treatment with gonadotropin releasing hormone analogue (GnRH-a=longacting D-Trp6-GnRH, 60 μg i.m. every 28 days). Before GnRH-a therapy, bone mineral density (BMD) was significantly higher in patients than in ten control girls matched for chronological age (patients 0.575±0.097 g/cm2, controls 0.433±0.049 g/cm2,P<0.001). Patient BMD was not significantly different from that of ten control girls matched according to patient bone age (0.550±0.046 g/cm2,P=NS). During GnRH-a treatment, pituitary-gonadal axis was suppressed and patient BMD significantly decreased (6 months: −6.0%,P<0.002 vs baseline; 12 months: −8.0%,P<0.001 vs baseline). We conclade that in girls with precocious puberty the activation of gonadal steroid secretion induces an increase in bone mineralization and that oestrogen deprivation by GnRH-a treatment caused a significant decrease in BMD.
Key wordsCentral precocious puberty Gonadotropin-releasing hormone analogue Bone mineralization Bone mineral density
bone mineral density
body mass index
central precocious puberty
gonadotropin releasing hormone analogue
Unable to display preview. Download preview PDF.
- 1.Aksnes L, Aarskog D (1982) Plasma concentrations of vitamin D metabolites in puberty: effect of sexual maturation and implication for growth. J Clin Endocrinol Metab 62:94–101Google Scholar
- 12.Greulich WW, Pyle SI (1959) Radiographic atlas of skeletal development of hand and wrist, 2nd edn. Stanford University Press, StanfordGoogle Scholar
- 15.Matta WH, Shaw RW, Hesp R, Evans R (1988) Reversible trabecular bone density loss following induced hypooestrogenism with the GnRH analogue buserelin in premenopausal women. Clin Endocrinol 29:45–51Google Scholar
- 18.Perren TJ, Clayton RN, Blackedge G (1986) Pharmacokinetic and endocrinological parameters of a slow-release depot preparation of the GnRH analogue ICI 118630 (Zoladex) compared with a subcutaneous bolus and continuous subcutaneous infusion of the same drug in patients with prostatic cancer. Cancer Chemother Pharmacol 18:39–43CrossRefPubMedGoogle Scholar
- 20.Roger M, Chaussain JL, Berlier P, Bost M, Canlorbe P, Colle M, Francoise R, Garandeau P, Lahlou N, Morel Y, Shally AV (1986) Long term treatment of male and female precocious puberty by administration of long-acting preparation ofd-Trp6-luteinizing hormone-releasing hormone microcapsules. J Clin Endocrinol Metab 62:670–677PubMedGoogle Scholar
- 31.Zachmann M (1992) Interrelations between growth hormone and sex hormones. Physiology and therapeutic consequences. The Third hGH Symposium Sorrento 1992, May 15–16, Sorrento, ItalyGoogle Scholar