Relationship between estrogen and C-type natriuretic peptide-induced pubertal linear growth |
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| Authors: | ZHENG Pi-mei MA Hua-mei SU Zhe CHEUNG Pik-to CHEN Qiu-li LI Yan-hong CHEN Hong-shan DU Min-lian |
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| Institution: | 1.Department of Pediatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China;2.Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR 999077, China. |
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| Abstract: | AIM：To explore the association between estrogen and C-type natriuretic peptide (CNP)-induced endochondral ossification in pubertal girls, and to investigate the relationship between CNP signaling pathway and the gonadotropin-releasing hormone analogue (GnRHa)-associated linear growth reduction in girls with idiopathic central precocious puberty (ICPP). METHODS：Serum levels of estradiol (E2), N-terminal propeptide of CNP (NT-proCNP), insulin-like growth factor 1 (IGF-1) and N-terminal mid-fragment of osteocalcin (N-MID OC) were measured in 56 healthy girls at different pubertal stages, and in 13 girls with ICPP at the beginning, the end of the 6th and 12th months of GnRHa treatment. Height velocity (HV) was also calculated. RESULTS：(1) Serum NT-proCNP, IGF-1, E2 and N-MID OC levels in the 56 healthy girls increased at early puberty compared with prepubertal levels (P<0.05 or P<0.01). Serum NT-proCNP level remained high at middle puberty and peaked at late puberty (P<0.05). Serum IGF-1 and E2 levels continued to increase at middle puberty (P<0.01) and peaked at late puberty (P<0.01). Serum N-MID OC level peaked at middle puberty (P<0.05) and decreased at late puberty (P<0.05). (2) The HV and serum levels of NT-proCNP and N-MID OC in the 13 ICPP girls decreased at the end of the 6th month of GnRHa treatment compared with those at the beginning of GnRHa treatment (P<0.05), and remained low at the end of the 12th month of GnRHa treatment. Serum IGF-1 level at the end of the 6th and 12th months of GnRHa treatment remained as the same as that at the beginning. Serum E2 returned to the prepubertal level after GnRHa treatment (P<0.05). CONCLUSION：Serum NT-proCNP level increases across female pubertal process and peaks at late puberty, in parallel with serum E2 and IGF-1 levels. Elevated estrogen in female puberty may be associated with CNP-mediated adolescent growth spurt. Serum NT-proCNP level in ICPP girls decreases during GnRHa treatment, in parallel with linear growth velocity and bone formation. Linear growth reduction in girls with ICPP treated with GnRHa is partly due to decreased CNP-mediated long bone growth after estrogen inhibition. |
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| Keywords: | Estrogen Gonadotropin-releasing hormone Puberty precocious Natriuretic peptide C-type |
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