GH and GHBP activity and not IGF-1 and its receptor activity express growth velocity reduction during treatment of central precocious puberty by a superactive GNRH analogue

R. Eshet, A. Silbergeld, R. Kauli, L. Lazar, Z. Laron

Research output: Contribution to journalArticlepeer-review

Abstract

We studied six patients with central precocious puberty (CPP) (five girls and one boy, aged 9-14.4 years) before and after 5 and 12 months of treatment with GnRH-A (D-TRP-6-LHRH-depo, DECAPEPTYL(®) Ferring, Sweden), and 14 age matched prepubertal children serving as controls. GnRH suppressed gonadal sex hormone secretion and arrested the gonadarche development. Growth velocity decreased from 9.8±1.6 (mean ± SD) to 4.6 ± 1.0 cm/year after 1 year of treatment. Basal serum IGF-1 levels of the CPP patients were 35.4 ± 2.8 nmol/l, which was significantly higher than that of the controls (18.8 ± 1.9, P = 0.00007). After GnRH-A there was a slight but significant increase in serum IGF-1 levels from 35.4 ± 2.8 (mean ± SE) to 40.3 ± 2.1 nmol/l after 5 months (mean difference of 4.9 ± 1.7, P = 0.02), reversing to 35.6 ± 2.8 nmol/l after 12 months. The number of high affinity IGF-1 binding sites on erythrocytes (RBC) in the controls was 3.3 ± 0.3 sites/cell, similar to that found in the patients before treatment. Following therapy, the number of the binding sites decreased from 4.0 ± 0.8 (mean ± SE) to 2.5 ± 0.6 sites/cell after 5 months (mean difference of -1.4 ± 0.5, P = 0.01), to 2.7 ± 0.7 sites/cell after 12 months. Basal levels of plasma GH in the CPP patients were 7.1 ± 1.3 ng/ml, significantly higher than those of the controls (1.2 ± 0.2, P = 0.00001). Treatment decreased plasma GH in patients from 7.1 ± 1.3 to 1.3 ± 0.3 ng/ml after 5 months (mean difference of -5.8 ± 1.3, P = 0.003) and to 2.7 ± 1.5 ng/ml after 12 months. The GH binding protein (GHBP) activity in the controls was 76.2 ± 6.2% relative specific binding, similar to that of the patients before therapy. The mean basal GHBP activity of the patients increased from 75.5 ± 73 to 101 ± 6.4% (mean difference of 25.5 ± 9.7, P = 0.01) after 5 months and to 90.1 ± 5.6% after 12 months of treatment. In conclusion, plasma GH and its receptor activity are a better indicator of the GnRH-A effect on growth than IGF-1 and its receptor activity.

Original languageEnglish
Pages (from-to)592-595
Number of pages4
JournalIsrael Journal of Medical Sciences
Volume30
Issue number8
StatePublished - 1994

Keywords

  • GHBP
  • GnRH-A treatment
  • IGF-1 receptor
  • Pediatrics
  • Precocious puberty

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