Objective To analyze the diagnostic value of insulin-like growth factor-1(IGF-1)and its related indexes for growth deceleration during the treatment of gonadotropin-releasing hormone analogue(GnRHa)in children with central precocious puberty(CPP),and to find out the best reference indexes and cut-off values to guide clinical work.Methods The clinical data[height,bone age(BA),growth velocity(GV),etc.]of 53 female children with idiopathic CPP treated with GnRHa were retrospectively analyzed.The correlation between IGF-1 and its related indexes,sex hormones and growth rate was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the best reference index of excessive growth deceleration in children with CPP.Results GV and GV SDS were positively correlated with△BA-IGF-1 SDS and estradiol(E2)at 12 months of treatment,and negatively correlated with BA-IGF-1 SDS at initial diagnosis(P<0.05).When the children were divided into GV SDS≥0 group and GV SDS<0 group,the area under the ROC curve of△BA-IGF-1 SDS was the largest[area under the curve(AUC)=0.782],and the optimal cut-off point was-1.274.Conclusion The growth deceleration during GnRHa treatment is related to the change of growth hormone(GH)-IGF-1 axis and the lack of sex steroids.△BA-IGF-1 SDS can be considered as a reference index for clinical guidance of combined use of recombinant human growth hormone(rhGH)after GnRHa treatment in children with CPP.
central precocious pubertygrowth velocityinsulin-like growth factor-1insulin-like growth factor binding protein-3
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