ESPE Abstracts

Objective: To explore the therapeutic effects and adverse reactions of a combination of letrozole or Gonadotropin releasing hormone analog (GnRHa) and recombinant human growth hormone (rhGH), compared with rhGH alone, in pubertal short boys.

Methods: Sixty-four pubertal short boys were divided into three groups, one group were treated with rhGH (rhGH group, n=21), one group were treated with the combination of GnRHa and rhGH (GnRHa group, n=19) and another group were treated with the combination of letrozole and rhGH (letrozole group, n=24). All boys had completed one or two years of treatments. The advancement of grow velocity, bone age (BA), height standard deviation score by bone age (Ht SDS_BA), while the body mass index (BMI), glucose and lipid metabolism, adverse reactions were measured.

Results: The ages of three groups were (12.79±0.98), (12.14±1.01) and (12.81±0.93) years (P>0.05), BA were (11.66±1.14), (12.97±0.90) and (13.27±0.75) years (P<0.05). The growth velocities of the first year were (10.75±1.56), (8.01±1.69), (10.11±2.19) cm/year (P<0.05), there were (9.44±1.53), (6.06±1.53) and (7.39±2.08) cm/year in the second year (P<0.05). The increasing of BA of the first year were (1.67±1.01), (0.71±0.36 ) and (0.58±0.30)year/year(P<0.05), there were (1.13±0.43 ), (0.61±0.37) and (0.47±0.22)year/year(P<0.05), there were no significant difference in BA after treatment for two years. Increase of HtSDS_BA in the first year were (0.05±0.88), (0.50±0.28) and (0.94±0.47), (P<0.05), there were (0.35±0.37), (0.26±0.29) and (0.81±0.46) (P<0.05) in the second year. There were no statistically significant difference of BMI, glucose and lipid metabolism between the three groups. During the treatment of combination group 3 boys suffered fractures, ultrasound bone density scan showed serious shortage of bone mineral density, after supplemental calcium and calcitriol, bone density increased within 3 to 6 months, no recurrence of fracture. There were no other adverse reactions in three groups.

Conclusion: Combination of letrozole and rhGH in pubertal short boys could inhibit BA progression, reduce growth slowdown, ameliorate Ht SDS_BA compare to the combination of GnRHa and rhGH, but bone density may be affected, and long-term follow-up is needed.