• Clinical and Experimental Pediatrics
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• 제58권1호
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• pp.1-7
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• 2015

Gonadotropin-releasing hormone analogs (GnRHa) are widely used to treat central precocious puberty (CPP). The efficacy and safety of GnRHa treatment are known, but concerns regarding long-term complications are increasing. Follow-up observation results after GnRHa treatment cessation in female CPP patients up to adulthood showed that treatment (especially <6 years) was beneficial for final adult height relative to that of pretreated or untreated patients. Puberty was recovered within 1 year after GnRHa treatment discontinuation, and there were no abnormalities in reproductive function. CPP patients had a relatively high body mass index (BMI) at the time of CPP diagnosis, but BMI standard deviation score maintenance during GnRHa treatment seemed to prevent the aggravation of obesity in many cases. Bone mineral density decreases during GnRHa treatment but recovers to normal afterwards, and peak bone mass formation through bone mineral accretion during puberty is not affected. Recent studies reported a high prevalence of polycystic ovarian syndrome in CPP patients after GnRHa treatment, but it remains unclear whether the cause is the reproductive mechanism of CPP or GnRHa treatment itself. Studies of the psychosocial effects on CPP patients after GnRHa treatment are very limited. Some studies have reported decreases in psychosocial problems after GnRHa treatment. Overall, GnRHa seems effective and safe for CPP patients, based on long-term follow-up studies. There have been only a few long-term studies on GnRHa treatment in CPP patients in Korea; therefore, additional long-term follow-up investigations are needed to establish the efficacy and safety of GnRHa in the Korean population.

• Fisheries and Aquatic Sciences
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• 제3권1호
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• pp.37-43
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• 2000

We used a mammalian GnRH antagonist, $[Ac-3,4-dehydro-Pro^1,\;D-p-F-Phe^2,\;D-Trp^{3.6}]$-GnRH, to examine the details of the salmon type gonadotropin-releasing hormone (sGnRH) and GnRH agonist analog $(Des-Gly^{10}$[d-Ala^6]-ethylamide GnRH; GnRHa) functions in the control of maturational gonadotropin (GTH II) secretion, in precocious male rainbow trout, in both in vivo and in vitro experiments. In the in vivo study, plasma GTH II levels increased by sGnRH or GnRHa treatment, but the response was more rapid and stronger in the GnRHa treatment group. The increase in GTH II was significantly suppressed by the GnRH antagonist, while the antagonist had no effect on basal GTH II levels in both groups. The GnRH antagonist showed stronger suppression of GTH II levels in the sGnRH treatment fish than in the GnRHa treatment fish. In addition, plasma androgenic steroid hormones (testosterone and 11-ketotestosterone) increased by the sGnRH or GnRHa treatment. The GnRH antagonist significantly inhibited the increases in plasma androgenic steroid hormone levels stimulated by the sGnRH or GnRHa, while the antagonist had no effect on basal androgenic steroid hormone levels in both groups. In the in vitro study, treatment with sGnRH or GnRHa increased GTH II release from the cultured dispersed pituitary cells, but the response was stronger in the GnRHa treatment group. The increase in GTH II release by GnRH was suppressed by adding the GnRH antagonist, dose­dependently. On the other hand, basal release of GTH II did not decrease by the GnRH antagonist treatment in both groups. These results suggest that the GnRH antagonist, $[Ac-3,4-dehydro-Pro^1,\;D-p-F-Phe^2,\;D-Trp^{3.6}]-GnRH$, used in this study is effective in blocking the action of GnRH-induced GTH II release from the pituitary gland both in vivo and in vitro.

• Clinical and Experimental Pediatrics
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• 제49권3호
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• pp.305-311
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• 2006

목 적 : 성조숙증은 사춘기가 일찍 발생함으로써 최종성인키의 저하가 초래되는 질환으로 사춘기 발현을 억제하여 최종성인키를 향상시키기 위하여 사용되는 성선자극호르몬방출호르몬유도체(gonadotropin releasing hormone agonist, GnRHa)와 일부환자에서 병합치료로 이용되는 성장호르몬(GH)의 치료 효과를 알아보고자 하였다. 방 법 : 1989-2003년까지 서울대학교병원 소아과에서 특발성진성 성조숙증으로 진단 받고 2년 이상 GnRHa를 투여한 21명과 성장호르몬의 병합치료를 시행한 9명에 대하여 2년간의 성장 속도, 예측성인키(predicted adult height, PAH)를 조사하였으며, GnRHa만 투여받은 15명과 성장호르몬을 병합투여받은 6명에서 최종성인키 차이를 후향적으로 비교 분석하였다. 모든 분석은 GnRHa 치료 전 예측성인키가 중간부모키-5 cm(성인여성의 키 1 표준편차)보다 작은 군(PAH_L)과 큰 군(PAH_H), 성장호르몬 병합치료군(GnRHa+GH)으로 구분하여 시행하였다. 결 과 : GnRHa 치료에 따른 PAH의 증가는 PAH_L군에서 첫 1년 동안에 관찰되어, PAH(키 SDS)는 치료 시작 시 $149.7{\pm}6.4cm(-2.1{\pm}1.3)$에서 1년 후에는 $153.5{\pm}6.5cm(-1.4{\pm}1.3)$로 유의하게 증가하고(P=0.004), 2년째에는 $155.8{\pm}8.0cm(-0.9{\pm}1.6)$이었다. 이 시기 동안에 성장속도는 $6.2{\pm}0.7cm$/년이였으며, 골연령 증가(골연령-역연령) 정도는 변화가 없었다. PAH_H군에서는 치료 전 PAH(키 SDS) $160.0{\pm}4.4cm(-0.1{\pm}0.9)$에서 변화가 없어 2년째 $159.5{\pm}6.0cm(-0.2{\pm}1.2)$였다. GnRHa+GH군은 첫 GnRHa 치료시의 PAH는 $149.4{\pm}7.8cm$로 PAH_L군과 비슷하며, 평균 2.3년 동안 GnRHa로 치료받은 후 PAH(키 SDS)는 $154.0{\pm}5. cm(-1.7{\pm}0.9)$로 증가하였으나(P=0.065), GnRHa 투여군들과는 차이가 없었다. 성장호르몬을 병합 투여한 후에 첫 1년 동안 성장속도가 $8.0{\pm}2.8cm/yr$로 치료 전 성장속도 $4.7{\pm}1.2cm/yr$에 비하여 유의하게 증가하여(P=0.013), 결국 1년째 PAH(키 SDS)가 $159.6{\pm}4.4cm(-0.4{\pm}0.6)$로 병합치료 전에 비하여 유의하게 증가하였으며, 2년째는 증가보다는 유지되는 정도였다. PAH_L군(N=8)의 최종성인키(키 SDS)는 $159.8{\pm}5.2cm(-0.1{\pm}1)$로 치료 전에 비하여 $8.5{\pm}2.2cm$ 커졌으며(P<0.001), PAH_H군(N=7)의 최종성인키(키 SDS)는 $156.5{\pm}5.1cm(-0.8{\pm}1)$로 치료 전 예측성인키(SDS) $158.6{\pm}3.8cm(-0.4{\pm}0.8)$, 중간부모키 $157.9{\pm}5.1cm(-0.4{\pm}0.9)$와 차이가 없었다. GnRHa+GH군(N=6)의 최종성인키(키 SDS)는 $158.7{\pm}3.7cm(-0.3{\pm}0.7)$로 GnRHa 치료 전 및 성장호르몬 병합치료 전 예측성인키(키 SDS)에 비하여 각각 평균 11.8 cm, 6.2 cm 증가하였으며(P<0.05), 중간부모키와 비슷하였다. 결 론 : GnRHa 투여의 효과는 첫 1년째에 중간부모키에 비하여 치료 전 예측성인키가 작은 환자에서 뚜렷하게 나타나며, GnRHa 투여 중 성장속도가 저하되면서 예측성인키와 중간부모 키가 작은 환자에서 성장호르몬을 병합 투여하면 중간부모키와 비슷한 최종성인키를 얻을 수 있을 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• 제60권12호
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• pp.395-402
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• 2017

Purpose: The potential effect of gonadotropin-releasing hormone agonist (GnRHa) treatment on the weight of girls with central precocious puberty (CPP) remains a controversy. We investigated anthropometric changes during and after GnRHa treatment among girls with CPP. Methods: This retrospective study evaluated data from 127 girls with CPP who received GnRHa treatment for ${\geq}2years$. Height, weight, and body mass index (BMI) values were compared at the baseline (visit 1), after 1 year of GnRHa treatment (visit 2), the end of GnRHa treatment (visit 3), and 6-12 months after GnRHa discontinuation (visit 4). Results: The height z score for chronological age (CA) increased continuously between visit 1 and visit 4. No significant differences were observed in BMI z score for CA between visits 1 and 4. However, an increasing trend in the BMI z score for bone age (BA) was observed between visits 1 and 4. The numbers of participants who were of normal weight, overweight, and obese were 97, 22, and 8, respectively, at visit 1, compared to 100, 16, and 11, respectively, at visit 4 (P=0.48). Conclusion: Among girls with CPP, the overall BMI z score for CA did not change significantly during or after GnRHa treatment discontinuation, regardless of their BMI status at visit 1. However, the BMI z score for BA showed an increasing trend during GnRHa treatment and a decreasing trend after discontinuation. Therefore, long-term follow-up of BMI changes among girls with CPP is required until they attain adult height.

• 한국양식학회지
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• 제18권4호
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• pp.293-298
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• 2005

RT-PCR을 이용하여 감성돔의 뇌하수체에서 발현하는 FSH$\beta$와 LH$\beta$ cDNA를 각각 cloning하였다. GenBank를 이용하여 FSH$\beta$와 LH$\beta$ 아미노산 배열과 상동성을 비교한 결과, 감성돔 FSH$\beta$는 참돔 FSH$\beta$와 $83.3\%$, snakehead fish FSH$\beta$와 $79.2\%$ 및 striped bass FSH$\beta$와 $76.0\%$의 상동성이 나타났으며 , 감성돔 LH$\beta$는 yellowfin seabream LH$\beta$와 $97.7\%$, 참돔 LH$\beta$와 $96.2\%$의 높은 상동성을 보였다. 또한, 본 연구에서는 1년생 수컷 감성돔에 GnRHa를 처리한 후, 뇌하수체에서 발현하는 GTH subunit mRNA의 농도와 혈중 T및 혈중 $E_2$ 농도의 변화를 조사하였다. GnRHa를 체중 g당 $0.2\;{\mu}g$으로 복강 주사한 후 0, 6, 12, 24 및 48시간제에 뇌하수체와 혈액을 샘플링한 결과, 호르몬 처리 후 6시간째에 FSH$\beta$ mRNA가 유의적으로 증가하였으나, LH$\beta$ mRNA 발현에는 유의적인 차이가 없었다. 또한 혈중 T와 혈중 $E_2$ 농도는 GnRHa처리 후 24시간째 유의적으로 증가하였다.

• Clinical and Experimental Reproductive Medicine
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• 제47권4호
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• pp.300-305
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• 2020

Objective: The feasibility of a gonadotropin-releasing hormone agonist (GnRHa) trigger in normal responders is still a matter of debate. The aim of this study was to compare the number of mature oocytes, the number of good-quality embryos, and the live birth rate in normal responders triggered by GnRHa alone, GnRHa and human chorionic gonadotropin (hCG; a dual trigger), and hCG alone. Methods: A retrospective cohort study was conducted at the infertility clinic of a university hospital. Data from 200 normal responders who underwent controlled ovarian hyperstimulation and intracytoplasmic sperm injection with a GnRH antagonist protocol between January 2016 and January 2017 were reviewed. The first study group consisted of patients with cycles triggered by GnRHa alone. The second study group consisted of patients with cycles triggered by both GnRHa and low-dose hCG (a dual trigger). The control group consisted of patients with cycles triggered by hCG alone. Results: The groups were comparable in terms of demographics and cycle characteristics. The numbers of total oocytes retrieved and metaphase II oocytes were similar between the groups. The total numbers of top-quality embryos were 3.2±2.9 in the GnRHa group, 4.4±3.2 in the dual-trigger group, and 2.9±2.1 in the hCG group (p=0.014). The live birth rates were 21.4%, 30.5%, and 28.2% in those groups, respectively (p=0.126). Conclusion: In normal responders, a dual-trigger approach appears superior to an hCG trigger alone with regard to the number of top-quality embryos produced. However, no clinical benefit was apparent in terms of live birth rates.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권2호
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• pp.130-138
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• 2016

Purpose: This study was conducted to analyze the change in the obesity index in girls receiving a gonadotropin-releasing hormone agonist (GnRHa), based on treatment duration, and to aid in nutritional counseling by investigating dietary habits and lifestyle. Methods: Anthropometric examinations were conducted on 62 girls treated with GnRHa from January 2010 through July 2014. Parents were asked to fill out questionnaires on patient dietary habits and lifestyle. Results: The group taking GnRHa for over 1 year had a higher rate of obesity increase than the group taking GnRHa for less than 1 year, but they had common habits related to obesity, which should be corrected. In addition, 69.2% of the normal weight group taking GnRHa for over 1 year gained weight, and needed more intensive programs, which include physical exercise and nutritional education. Although girls with precocious puberty showed a decrease in the intake of high-calorie foods with nutritional intervention regardless of treatment duration, they still had problems that needed improvement, such as shorter meals and lack of exercise. Conclusion: Girls with precocious puberty and their parents should emphasize maintenance of proper body weight, especially when treatment for over 1 year is anticipated. Consistent education in nutrition, ways to increase intensity and duration of physical activity, and the need to slow down mealtimes are important in managing obesity; doctors need to perform regular checkups and provide nutritional counseling.

• Clinical and Experimental Pediatrics
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• 제49권5호
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• pp.552-557
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• 2006

목 적 : 최근 성조숙증에서 사춘기를 중단시킴으로써 성인신장을 증가시킬 수 있으리라는 기대로 조기 사춘기로 인하여 신장에 대한 예후가 불량한 소아에서 성선자극호르몬 방출호르몬 효능약제의 시도가 이루어졌다. 이에 저자들은 조기 사춘기로 예측 성인신장이 저하된 여아에서 이 약제의 신장 증가효과를 분석하고자 하였다. 방 법 : 소아과 외래에 조기 사춘기와 예측성인신장이 저신장으로 예측되는 36명의 여아를 대상으로 GnRHa를 6개월 이상 사용한 제 1군과 6개월 미만 사용한 제 2군으로 나누어 치료 시작시와 치료 후의 역연령, 골연령, 신장 및 표준편차치, 예측성 인신장 및 표준편차치, 표적키 및 표준편차치, 혈청 IGF-1, IGFBP-3 치를 비교하였다. 결 과 : 1군의 평균 치료기간은 $1.37{\pm}0.92$년, 2군은 $0.41{\pm}0.08$년이었고, 전체적으로는 $0.89{\pm}0.81$년이었다. 치료 시작시 두군 간에 역연령, 골연령, 신장, 표적키, 예측성인신장, 혈청 IGF-1 및 IGFBP-3 치의 차이는 없었고, 마지막 추적시 두 군간에 역연령, 골연령, 신장, 예측성인신장, 혈청 IGF-1 및 IGFBP-3치의 차이도 없었다. 두 군 사이에 성장속도와 치료기간에 따른 예측성인신장의 증가분은 2군이 의미 있게 높았다. 이는 2군이 치료기간이 짧아 사춘기의 성장속도가 충분히 억제되지 않은 결과로 보인다. 치료 시작시에 비하여 마지막 추적시의 예측성인신장은 의미 있게 증가하여 단기간의 치료에도 어느 정도의 효과($3.7{\pm}3.2cm$)는 있었다. 전체 대상아에서 표적키($157.3{\pm}3.1cm$)와 치료 시작시 예측성인신장($148.5{\pm}5.8cm$) 사이에는 의미있는 차이가 있었으며, 마지막 추적시의 예측성인신장($152.2{\pm}5.9cm$) 사이에도 의미 있는 차이가 있었다. 검사 소견에서 혈청 IGF-1과 IGFBP-3는 치료 시작시에 비하여 마지막 추적시에는 의미 있게 감소하여 GnRHa의 사용으로 성장호르몬-IGF 축이 다소간 억제되는 것으로 보인다. 결 론 : 사춘기가 조기에 시작하여 골연령이 역연령에 비하여 증가되어 예측성인신장이 표적키에 못 미치는 경우에 단기간의 GnRHa의 사용으로 예측성인신장은 다소 증가하였으나 표적키에는 미치지 못함을 알 수 있었으며, 성장호르몬-IGF 축의 억제가 동반되는 점에서 GnRHa 치료시 예측성인신장이 표적키에 이르기 위해서는 성장호르몬의 동시 사용이 필요하겠다.

• 한국수산과학회지
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• 제40권6호
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• pp.374-379
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• 2007

Two experiments were designed to examine short-term effects of human chorionic gonadotropin (hCG), and long-term effects of gonadotropin-releasing hormone agonist (GnRHa), $17{\alpha}-hydroxyprogesterone$ (17P), and $17{\alpha},20{\beta}-dihydroxy-4-pregnen-3-one\;(17,20{\beta}P)$, alone or in combination, on milt production of the starry flounder Platichthys stellatus. In the first experiment, fish were injected with either 200 IU hCG/kg body weight or the same volume of marine fish Ringer's solution (MFRS). In the second experiment, each fish was implanted with a blank cholesterol pellet (control), $200\;{\mu}g$ GnRHa, $500\;{\mu}g$ 17P, or $100\;{\mu}g\;17,20{\beta}P/kg$ body weight alone or in combination. In the first experiment, hCG injection resulted in an increase in the expressible milt volume and a decrease in the spermatocrit (Sct). After pellet implantation in the second experiment, the milt volume was increased in males treated with GnRHa, GnRHa+17P, or $GnRHa+17,20{\beta}P$. On day 7 after hormone pellet implantation, the milt volume began to increase, and on day 14, the milt volume in the $GnRHa+500\;{\mu}g$ 17P group was significantly higher than that in the control group. Compared with the control group, the hormone pellet-treated groups had a significant reduction in the mean Sct and sperm concentration (Sc) at day 7 after pellet implantation, while there were no differences in total sperm number. The results suggest that increases in milt volume are generally associated with decreases in Sct and SC, suggesting that the main mechanism for the increase in milt volume was milt hydration.

• Clinical and Experimental Pediatrics
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• 제49권7호
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• pp.718-725
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• 2006

The pubertal activation of gonadotrophin releasing hormone(GnRH) requires coordinated changes in excitatory or inhibitory amino acids, growth factors, and a group of transcriptional regulators. The age of onset of puberty is progressing to younger age. Factors affecting early puberty include genetic traits, nutrition(body fat) and exposure to endocrine disrupting chemicals. In rapidly progressing central precocious puberty, gonadotrophin releasing hormone(GnRH) agonists(GnRHa) appear to increase final height if treated early stage. Further large scaled long-term follow-up study of the effects of GnRHa on final height is needed.