Ann Pediatr Endocrinol Metab.  2014 Dec;19(4):214-219. 10.6065/apem.2014.19.4.214.

Adult height in girls with central precocious puberty treated with gonadotropin-releasing hormone agonist with or without growth hormone

• Jung MK
• Song KC
• Kwon AR
• Chae HW
• Kim DH
• Kim HS

• KMID: 1769355
• DOI: http://doi.org/10.6065/apem.2014.19.4.214

Abstract

PURPOSE
There is controversy surrounding the growth outcomes of treatment with gonadotropin-releasing hormone agonist (GnRHa) in central precocious puberty (CPP). We analyzed height preservation after treatment with GnRHa with and without growth hormone (GH) in girls with CPP.
METHODS
We reviewed the medical records of 82 girls with idiopathic CPP who had been treated with GnRHa at Severance Children's Hospital from 2004 to 2014. We assessed the changes in height standard deviation score (SDS) for bone age (BA), and compared adult height (AH) with midparental height (MPH) and predicted adult height (PAH) during treatment in groups received GnRHa alone (n=59) or GnRHa plus GH (n=23).
RESULTS
In the GnRHa alone group, the height SDS for BA was increased during treatment. AH (160.4+/-4.23 cm) was significantly higher than the initial PAH (156.6+/-3.96 cm) (P<0.001), and it was similar to the MPH (159.9+/-3.52 cm). In the GnRHa plus GH group, the height SDS for BA was also increased during treatment. AH (159.3+/-5.33 cm) was also higher than the initial PAH (154.6+/-2.55 cm) (P<0.001), which was similar to the MPH (158.1+/-3.31 cm). Height gain was slightly higher than that in the GnRHa alone group, however it statistically showed no significant correlation with GH treatment.
CONCLUSION
In CPP girls treated with GnRHa, the height SDS for BA was increased, and the AH was higher than the initial PAH. Combined GH treatment showed a limited increase in height gain.

Keyword

Central precocious puberty; Gonadotropin-releasing hormone; Growth hormone; Treatment outcome

MeSH Terms

Adult*
Female
Gonadotropin-Releasing Hormone*
Growth Hormone*
Humans
Medical Records
Puberty, Precocious*
Treatment Outcome
Gonadotropin-Releasing Hormone
Growth Hormone

Figure

• 

  Fig. 1 Changes in height standard deviation score (SDS) for bone age (BA) during treatment in 59 central precocious puberty (CPP) patients treated with gonadotropin-releasing hormone agonist (GnRHa) alone (♦) and in 23 CPP patients treated with GnRHa plus GH (▪). AH, adult height; GH, growth hormone.***P<0.001 vs. start of GnRHa treatment.

• 

  Fig. 2 Initial predicted height, midpatental height and ault height of 59 central precocious puberty (CPP) patients treated with gonadotropin-releasing hormone agonist (GnRHa) alone and in 23 CPP patients treated with GnRHa plus growth hormone (GH). PAH, predicted adult height; AH, adult height; MPH, midparental height. ***P<0.001 vs. initial PAH.

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