EFFECTS OF LUTEINIZING-HORMONE-RELEASING HORMONE ANALOG-INDUCED PUBERTAL DELAY IN GROWTH-HORMONE (GH)-DEFICIENT CHILDREN TREATED WITH GH - PRELIMINARY-RESULTS

To study the effect of delaying epiphyseal fusion on the growth of GH- deficient children, we studied 14 pubertal, treatment naive, GH-defici ent patients (6 girls and 8 boys) in a prospective, randomized, placeb o-controlled trial. Chronological age was 14.5 +/- 0.5 yr, and bone ag e was 11.6 +/- 0.3 yr (mean +/- SEM) at the beginning of the study. Pa tients were assigned randomly to receive GH and LH-releasing hormone ( LHRH) analog (n = 8) or GH and placebo (n = 6) during 3 yr, with plann ed continuation of GH treatment until epiphyseal fusion. Patients were measured with a stadiometer and had serum LHRH tests, serum testoster one (boys), serum estradiol (girls), and bone age performed every 6 mo nths. Patients treated with GH and LHRH analog showed a clear suppress ion of their pituitary-gonadal axis and a marked delay in bone age pro gression. We observed a greater gain in height prediction in these pat ients than in the patients treated with GH and placebo after 3 yr of t reatment (mean +/- SEM, 14.0 +/- 1.6 vs. 8.0 +/- 2.4 cm; P < 0.05). Th ese preliminary findings suggest that delaying epiphyseal fusion with LHRH analog in pubertal GH-deficient children treated with GH increase s height prediction and may increase final height compared to treatmen t with GH alone.