진성 성조숙증 환자의 생식샘 자극 호르몬 유사체 치료 중에신체 계측치의 변화
Auxological Effects of Gonadotropin-releasing Hormone Agonist Treatment for Central Precocious Puberty
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목 적:진성 성조숙증의 GnRH agonist 치료가 환아의 신장, 체중, 체질량지수에 어떤 영향을 미치는 지 연구하였다. 방 법:이화여대 부속 목동병원에서 진성 성조숙증의 치료로 leuprorelin acetate를 투여받고 있는 여아 34명을 대상으로 치료 시작 전과 6개월, 12개월, 18개월, 24개월 후 신장, 체중, 체질량지수를 측정하여 각 측정치의 변화량과 각 측정치의 표준편차점수 변화를 비교하였다. 결 과:역연령에 대한 체중 표준편차점수는 증가하는 경향을 보였으나 유의하지 않았다. GnRH agonist 치료 동안 역연령에 대한 신장 표준편차점수는 감소하는 경향을 보였으나 유의하지 않았고 골연령에 대한 신장 표준편차점수는 의미있게 증가하였다(P˂0.05). 역연령에 대한 체질량지수는 치료 6개월까지 감소했으나 치료 6개월 이후에 증가하는 경향을 보였다. 치료 시작 시 과체중이었던 환아는 정상 체중아에 비해 체질량지수 표준편차점수가 치료 시작 1년 후부터 증가하는 경향을 보였다. 결 론:진성 성조숙증 환자의 GnRH agonist 치료 기간 동안 골연령에 대한 신장의 증가를 보였으나, 특히 과체중아에서 체질량지수가 증가하는 경향을 보였으므로, GnRH agonist 치료시 식이조절과 운동량을 증가시켜 체중의 증가를 최소화하려는 노력이 필요하다.
Abstract
Purpose:The aim of our study was to assess the changes in the height, body weight, and body mass index (BMI) of children who were undergoing gonadotropin-releasing hormone agonist (GnRH agonist) treatment for central precocious puberty. Methods:We performed semester-wise analysis of the anthropometric data (height, body weight, and BMI) obtained from 34 girls treated with GnRH agonist. Results:We observed that body-weight standard deviation scores (SDS) for chronological age and bone age tended to increase during the treatment, but the increase was not significant. Furthermore, the height SDS for chronological age tended to decrease during the treatment, while the SDS for bone age significantly increased during the treatment. The BMI SDS for chronological age decreased during the first 6 months of treatment, but increased subsequently. After the first year of treatment, the BMI SDS of overweight girls tended to increase more than the BMI SDS of girls with normal weight. Conclusion:During GnRH agonist treatment for central precocious puberty, the BMI SDS tended to increase in overweight girls. The physical activity of such patients should be increased to minimize possible alterations in body composition.
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