The effect of gonadotropin-releasing hormone analog treatment on the endocrine system in central precocious puberty patients: a meta-analysis.

Huijuan Ma, Linlin Yang, Na Guo, Fei Zhou, Xiaolan Jiang

Journal: Journal of pediatric endocrinology & metabolism : JPEM 2024;37(3):197-208

PMID: 38235550

Abstract

OBJECTIVES

Gonadotropin-releasing hormone (GnRHa) is the first choice for the treatment of patients with central precocious puberty (CPP). However, the effects of GnRHa on the endocrine system of CPP patients, including insulin sensitivity, lipid level, thyroid function, bone mineral density (BMD), and testosterone (T) level, are currently contradictory. Therefore, the long-term safety of GnRHa therapy remains controversial.

CONTENT

A systematic literature search was performed using PubMed, Embase, Cochrane Library, and CNKI databases. The changes in HOMA-IR, TG, LDL-C, HDL-C, TSH, FT3, FT4, T, and BMD in CPP patients before and after GnRHa treatment were compared by meta-analysis. As the heterogeneity between studies, we estimated standard deviation mean differences (SMDs) and 95 % confidence intervals (CIs) using a random-effects model. Egger's test was used to assess publication bias.

SUMMARY

A total of 22 studies were included in our meta-analysis. Compared with before GnRHa treatment, there were no statistically significant differences in endocrine indicators including HOMA-IR, TG, LDL-C, HDL-C, TSH, FT4, FT3, T, and BMD of CPP patients treated with GnRHa.

OUTLOOK

Treatment with GnRHa for central precocious puberty will not increase the adverse effect on the endocrine system.

© 2024 Walter de Gruyter GmbH, Berlin/Boston.

Address: Graduate School of Hebei North University, Zhangjiakou, Hebei, P.R. China.; Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China.; Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China.; Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, P.R. China.; Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China.; Data Center, The First Hospital of Hebei Medical University, Hebei, 050031, P.R. China.; Department of Endocrinology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China.

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