The Effect of Gonadotropin Releasing Hormone Analogue and Growth Hormone on Final Height in Children with Advanced Puberty

Seo, Ji Young; Jung, Hye Lim; Shin, Choong Ho; Yang, Sei Won

Abstract

PURPOSE: Gonadotropin releasing hormone analogue (GnRHa) or growth hormone (GH) improve final height in girls with central precocious puberty. We studied the effect of these agents on adult height in children with advanced puberty.
METHODS
We analysed height, bone age, growth velocity, predicted adult height (PAH), and final adult height (FAH) in 61 girls and 19 boys with advanced puberty, who were treated with GnRHa combined GH or GH.
RESULTS
In Girls 1) FAH (SDS) of combination group (GnRHa+GH, n=7) was similar to their pretreatment PAH (SDS) [153.9+/-6.0 cm (-1.3+/-1.2) vs 152.8+/-4.7 cm (-1.5+/-0.9)]. In GH group (n=18), FAH was significantly increased [155.7+/-4.9 cm (-0.9+/-1.0) vs 149.9+/-4.6 cm (-2.1+/-0.9)] (P<0.001). 2) PAH (SDS) of combination group increased from 151.5+/-5.9 cm (-1.8+/-1.2) to 157.8+/-7.1 cm (-0.5+/-1.4) and that of GH group increased from 149.5+/-5.9 cm (-2.2+/-1.2) to 155.8+/-5.8 cm (-0.9+/-1.2) (P<0.001). During first year of treatment, growth velocity of GH group was significantly higher than that of combination group (6.6+/-2.1 cm/year vs 9.4+/-2.5 cm/year, P=0.001) In boys 1) In both group (7 boys of combination group and 8 boys of GH group), FAH was similar to their pretreatment PAH and their growth velocity during first year of treatment had no significant difference (7.6+/-2.3 cm/year vs 9.2+/-2.9 cm/year).
CONCLUSION
In girls with advanced puberty, GnRHa delayed bone maturation but had no significant effect on FAH. In contrast, GH increased FAH through increment of growth velociy. In boys with advanced puberty, no significant effect of GnRHa or GH.