Effects of combined GnRHa and letrozole on serum steroid profiles in girls with advanced bone age
- 1Department of Pediatrics, The Second Hospital of Hebei Medical University
- 2Kingmed Diagnostics (Beijing) Co., Ltd
- 3College of Chemistry, Beijing University of Chemical Technology
Abstract
Objective: To evaluate the impact of combined GnRHa and letrozole on serum steroid profiles (classical, 11‐oxygenated, and backdoor androgen pathways) in girls with advanced bone age, and to monitor adverse events.
Methods: 28 girls with advanced bone age were enrolled. Of these, 15 received add‐on letrozole after GnRHa monotherapy (Group B); the remaining 13 started combination therapy from baseline (Group A). Blood was collected at baseline, 1, and 6 months. Steroids were measured by LC‐MS/MS.
Results: At baseline, Group A had higher classical androgens, progestogens, estrogens, INB, SHBG, and FAI than Group B (all P < 0.05), while 11‐oxygenated androgens were similar. In Group A, classical androgens, P, 17‐OHP, 5α‐DHP, 17OH‐DHP, 3α‐diol, E1, E2, and FAI decreased markedly (all overall P < 0.01) and remained lower at 6 months; 11‐KT showed a modest reduction at 1 month ( P = 0.02), but other 11‐oxygenated androgens were unchanged. In Group B, add‐on letrozole reduced E1, E2, AMH, and INB (all overall P < 0.05), while most androgens and progestogens were stable. No hyperandrogenism or adverse events were observed.
Conclusions: Over 6 months, combined GnRHa and letrozole was not associated with hyperandrogenism in girls with advanced bone age. In Group A, gonadal androgens and estrogens were markedly suppressed, while adrenal androgens remained stable. In Group B, add‐on letrozole had limited effects on most androgens. Estrogen suppression was observed in both groups. These findings appear to support short‐term safety, although longer‐term data are needed.
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BibTeX
@article{zhang2026effects,
title = {{Effects of combined GnRHa and letrozole on serum steroid profiles in girls with advanced bone age}},
author = {Xuan Zhang and Yanan Zhang and Yutong Xing and Wenqing Yang and Yueqiu Qin and Xuehan Gao and Xujing Kong and Susu Cai and Guocui Xue and Xiaomin Fan and Mingzhao Chen and Yongqi Liu and Baorong Chen and Xue Yan and Huifeng Zhang},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1984633},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1984633/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effects of combined GnRHa and letrozole on serum steroid profiles in girls with advanced bone age
AU - Xuan Zhang
AU - Yanan Zhang
AU - Yutong Xing
AU - Wenqing Yang
AU - Yueqiu Qin
AU - Xuehan Gao
AU - Xujing Kong
AU - Susu Cai
AU - Guocui Xue
AU - Xiaomin Fan
AU - Mingzhao Chen
AU - Yongqi Liu
AU - Baorong Chen
AU - Xue Yan
AU - Huifeng Zhang
PY - 2026
DA - 2026/10/15
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1984633
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1984633/full
AB - Objective: To evaluate the impact of combined GnRHa and letrozole on serum steroid profiles (classical, 11‐oxygenated, and backdoor androgen pathways) in girls with advanced bone age, and to monitor adverse events. Methods: 28 girls with advanced bone age were enrolled. Of these, 15 received add‐on letrozole after GnRHa monotherapy (Group B); the remaining 13 started combination therapy from baseline (Group A). Blood was collected at baseline, 1, and 6 months. Steroids were measured by LC‐MS/MS. Results: At baseline, Group A had higher classical androgens, progestogens, estrogens, INB, SHBG, and FAI than Group B (all P < 0.05), while 11‐oxygenated androgens were similar. In Group A, classical androgens, P, 17‐OHP, 5α‐DHP, 17OH‐DHP, 3α‐diol, E1, E2, and FAI decreased markedly (all overall P < 0.01) and remained lower at 6 months; 11‐KT showed a modest reduction at 1 month ( P = 0.02), but other 11‐oxygenated androgens were unchanged. In Group B, add‐on letrozole reduced E1, E2, AMH, and INB (all overall P < 0.05), while most androgens and progestogens were stable. No hyperandrogenism or adverse events were observed. Conclusions: Over 6 months, combined GnRHa and letrozole was not associated with hyperandrogenism in girls with advanced bone age. In Group A, gonadal androgens and estrogens were markedly suppressed, while adrenal androgens remained stable. In Group B, add‐on letrozole had limited effects on most androgens. Estrogen suppression was observed in both groups. These findings appear to support short‐term safety, although longer‐term data are needed.
SN - 1664-2392
ER -