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Effects of Luteinizing Hormone-Releasing Hormone Analog-Induced Pubertal Delay in Growth Hormone (GH)-Deficient Children Treated with GH: Preliminary Results¹

Institute of Maternal and Child Research, University of Chile (F.C., V.M., M.E., A.A., C.G., A.F.), Santiago, Chile; and the Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health (S.R.R., G.B.C.), Bethesda, Maryland 20892

Address all correspondence and requests for reprints to: Fernando Cassorla, Institute of Maternal and Child Research, University of Chile, Casilla 226–3, Santiago, Chile.

To study the effect of delaying epiphyseal fusion on the growth of GH-deficient children, we studied 14 pubertal, treatment naive, GH-deficient patients (6 girls and 8 boys) in a prospective, randomized, placebo-controlled trial. Chronological age was 14.5 ± 0.5 yr, and bone age was 11.6 ± 0.3 yr (mean ± SEM) at the beginning of the study. Patients were assigned randomly to receive GH and LH-releasing hormone (LHRH) analog (n = 8) or GH and placebo (n = 6) during 3 yr, with planned continuation of GH treatment until epiphyseal fusion. Patients were measured with a stadiometer and had serum LHRH tests, serum testosterone (boys), serum estradiol (girls), and bone age performed every 6 months.

Patients treated with GH and LHRH analog showed a clear suppression of their pituitary-gonadal axis and a marked delay in bone age progression. We observed a greater gain in height prediction in these patients than in the patients treated with GH and placebo after 3 yr of treatment (mean ± SEM, 14.0 ± 1.6 vs. 8.0 ± 2.4 cm; P < 0.05). These preliminary findings suggest that delaying epiphyseal fusion with LHRH analog in pubertal GH-deficient children treated with GH increases height prediction and may increase final height compared to treatment with GH alone.

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