The alteration of IGF-1 levels and relationship between IGF-1 levels and growth velocity during GnRH analogue therapy

J Pediatr Endocrinol Metab. 2020 Jan 28;33(1):113-120. doi: 10.1515/jpem-2018-0482.

Abstract

Background Some studies have examined the effect of gonadal suppression on insulin-like growth factor-1 (IGF-1) levels and the growth velocity (GV) with conflicting results. Methods Forty-four girls treated with gonadotropin-releasing hormone analogue (GnRHa) for central precocious puberty (CPP) were included in the study. IGF-1 levels were examined at the beginning and after 12 months of treatment. Results IGF-1 and IGF-1 standard deviation score (SDS) according to chronological age (CA-IGF-1 SDS) at diagnosis were positively correlated with chronological age (CA), anthropometric measurements, stage of puberty, bone age (BA), BA-CA, follicle-stimulating hormone (FSH), luteinising hormone (LH), oestradiol, uterus length, endometrium thickness and ovarian volume (OV) at diagnosis (p < 0.05). There was no significant difference in IGF-1 levels after treatment. However, there was a negative correlation between ΔIGF-1 SDS and IGF-1 level, CA-IGF-1 SDS and BA-IGF-1 SDS at diagnosis (p < 0.05). There was no correlation between GV and IGF-1, ΔIGF-1. GV was negatively correlated with basal LH level at diagnosis (p = 0.008, r = -0.397). Peak LH levels of the patients who had GV-SDS < 0 were more suppressive than those of the patients who had GV-SDS > 0 after 12 months of treatment. Conclusions It was determined that the IGF-1 level and CA-IGF-1 SDS at baseline were correlated with more advanced pubertal stage prior to treatment. Initiation of treatment with a relatively high level of IGF-1 increased the risk of a decrease in the IGF-1 level. Likewise, the initiation of treatment with a relatively high LH level may increase the risk of low GV, but low GV was not related to the IGF-1 level. Increased sex steroid suppression may increase the risk of low GV.

Keywords: GnRHa treatment; IGF-1; growth velocity; precocious puberty.

MeSH terms

  • Body Height / drug effects*
  • Body Mass Index*
  • Child
  • Female
  • Gonadotropin-Releasing Hormone / agonists*
  • Growth / drug effects*
  • Humans
  • Insulin-Like Growth Factor I / analysis*
  • Prognosis
  • Prospective Studies
  • Puberty, Precocious / blood
  • Puberty, Precocious / drug therapy*
  • Sexual Maturation / drug effects*

Substances

  • IGF1 protein, human
  • Gonadotropin-Releasing Hormone
  • Insulin-Like Growth Factor I