Identificador: TDX:640
Autores: Llop Viñolas, Maria Dolors
Resumen:
Objectives: 1) To describe the characteristics of growth and pubertal development in girlsand boys with different ages of pubertal onset, including two frecuent clinical situations:advanced puberty in girls and delayed puberty in boys, 2) To describe the GnRH analoguestreatment effects in girls with advanced puberty, compared with a control group; 3) Todescribe the testosterone treatment effects in boys with delayed puberty compared with acontrol group.Patients and Methods: This project is composed of three studies, where children werestudied since the onset of puberty until the moment of attaintment of their final height. 1) Alongitudinal observational and prospective study, in 116 girls and 135 boys, with pubertalonset at 10-13 and 11-14 years of age respectively, grouped by age of pubertal onset. 2)Non-randomized clinical study in girls with advanced puberty (16 treated LHRH analogueduring 1 year and 16 control subjects) and 3) Non-randomized clinical study in boyswith delayed puberty (17 treated with testosterone during 6 months and 15 controlsubjects).In all the studies, we carried out anthropometric measurements (weight, height, skinfoldthicknesses and arm circumference) and we assessed pubertal maturation by means ofTanner stages. We calculated the body mass index, muscular area of the arm, the targetheight, the pubertal height growth (gain in height from the puberty onset up to the finalheight) and the pubertal duration (time in years from the puberty onset up to the age atwhich final height is attained). In boys, we analyzed the testicular volume and in girlsthe age of menarche. In the studies 2) and 3) we assessed the bone age and somehormonal analyses.Results and conclusions: 1) Both in girls and boys with different age of pubertal onset, thedifferent dynamics of development and pubertal growth, lead to attain similar finalheights.This is due to a compensation between a smaller height at pubertal onset in the earlymaturers, with a longer pubertal duration, greater pubertal growth and longer time betweenonset and menarche. 2) Treatment with LHRH analogue delayed the menarche age, led toan involution in secondary sexual characteristics and a temporary decrease in growth rate,and delayed skeletal maturation. However, pubertal duration, pubertal height growth andfinal heights were similar in both groups.3) Treatment with testosterone leads to the startof puberty, but without stopping the maturation of the hypothalamic-pituitary axis,allowing a normal testicular evolution. The final heights were similar in both groups. 4)Girls with advanced puberty and boys with delayed puberty present a dynamics ofgrowth and pubertal development which are similar of those presented by the girls andboys with puberal onset at normal ages. The attained final heights were similar in all theage groups.
Repositori URV