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

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.

Keywords: Central precocious puberty; Gonadotropin-releasing hormone; Growth hormone; Treatment outcome.

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.