Abstract:

Objective To investigate the effects of different therapy strategy，including single recombi⁃ nant human growth hormone（rhGH）use，combination of rhGH and letrozole，and combination of rhGH and GnRHa，in improving the prediction of final height in children diagnosed with adolescent idiopathic short stature （ISS）. Methods From May 2014 to June 2019，60 children with ISS in our hospital were randomly divided into three groups，20 cases in rhGH group（rhGH alone），20 cases in GnRHa group（rhGH combined with leuprorelin）， and 20 cases with letrozole group（treated with rhGH combined with letrozole）. All the three groups were treated and followed up for 1 year. Parameters of weight，growth rate，bone age，fasting blood glucose，glycosylated hemoglobin， IGF⁃1 and IGFBP3 were collected and analyzed to predict the final height and adverse reactions. Results：There was no significant difference in basic data among the three groups before treatment（P > 0.05）. After 1 year of treatment， the bone age of rhGH group（14.49 ± 0.51 years old）was higher than that of letrozole group（13.77 ± 0.74 years old） and GnRHa group（13.78 ± 0.52 years old）（P < 0.05）. The bone age growth of letrozole group（0.17 ± 0.14 years old）was significantly less than that of GnRHa group（0.49 ± 0.16 years old）and rhGH group（0.97 ± 0.13 years old） （P < 0.05）. The predicted final height in letrozole group（165.40 ± 2.57 cm）was significantly higher than that in GnRHa group（162.32 ± 2.82 cm）and rhGH group（161.32 ± 1.32 cm）（P < 0.05）. The predicted final height increase in letrozole group（6.86 ± 1.14 cm）was higher than that in GnRHa group（162.32 ± 2.82 cm），that in GnRHa group was higher than that in rhGH group（2.66 ± 0.71 cm）（P < 0.05）. The growth rate of letrozole group （8.19 ± 0.26 cm）and rhGH group（8.44 ± 0.94 cm）was significantly higher than that of GnRHa group（7.51 ± 0.96 cm）（P < 0.05）. There was no significant difference in fasting blood glucose，glycosylated hemoglobin，IGF ⁃ 1， IGFBP3 and adverse reactions among the three groups（P > 0.05）. Conclusion Letrozole is more effective than GnRHa in improving the predict final height of ISS in adolescence.

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