Ann Pediatr Endocrinol Metab.  2023 Mar;28(1):49-53. 10.6065/apem.2142250.125.

Effect of gonadotropin-releasing hormone agonist treatment on near final height in girls with central precocious puberty and early puberty

• Yang EH
• Jo HY
• Park SJ
• Yoo HW
• Choi SH
• Kim HY
• Park KH
• Kim YM
• Kwak MJ

• KMID: 2540787
• DOI: http://doi.org/10.6065/apem.2142250.125

Abstract

Purpose
The aim of this study was to examine whether gonadotropin-releasing hormone (GnRH) agonist treatment is effective in preserving final height in patients with central precocious puberty (CPP) or early puberty (EP).
Methods
The medical records of 40 patients with CPP and 206 patients with EP who completed GnRH agonist treatment following diagnosis were analyzed retrospectively. Height and height standard deviation (height SDS) scores based on bone age (BA) were measured and calculated at baseline, after treatment completion, and at final follow-up to compare changes within and between groups. Predicted adult height (PAH) was estimated by the height corresponding to height SDS for BA in girls at 18 years 11 months of age based on the growth chart.
Results
PAH at baseline did not differ significantly between the CPP group (153.67±4.95) and the EP group (154.77±3.72). In the CPP group, PAH significantly increased at treatment completion (156.01±4.61) and at final follow-up (158.52±6.04) compared to baseline. In the EP group, PAH significantly increased at treatment completion (157.7±3.60) and at final follow-up (159.31±4.26) compared to baseline. The increase in PAH at all timepoints compared to baseline did not significantly differ between the CPP and EP groups.
Conclusion
Both CPP and EP groups had significantly greater PAH after treatment, with no difference in the amount of increase between groups. These results show that GnRH agonist treatment can help increase final height even in patients diagnosed with EP after the age of 8 years.

Keyword

Precocious puberty; Central precocious puberty; Gonadotropin-releasing hormone agonist

Figure

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  Fig. 1. Correlation between change in PAH (ΔPAH) and the difference between BA and CA (BA-CA) at the start of treatment in the EP group. PAH, predicted adult height; BA, bone age; CA, chronological age.

Reference

References

1. Bangalore Krishna K, Fuqua JS, Rogol AD, Klein KO, Popovic J, Houk CP, et al. Use of gonadotropin-releasing hormone analogs in children: update by an international consortium. Horm Res Paediatr. 2019; 91:357–72.

2. Klein KO, Barnes KM, Jones JV, Feuillan PP, Cutler GB Jr. Increased final height in precocious puberty after long-term treatment with LHRH agonists: the National Institutes of Health experience. J Clin Endocrinol Metab. 2001; 86:4711–6.

3. Carel JC, Roger M, Ispas S, Tondu F, Lahlou N, Blumberg J, et al. Final height after long-term treatment with triptorelin slow release for central precocious puberty: importance of statural growth after interruption of treatment. French study group of Decapeptyl in Precocious Puberty. J Clin Endocrinol Metab. 1999; 84:1973–8.

4. Lee SJ, Yang EM, Seo JY, Kim CJ. Effects of gonadotropin-releasing hormone agonist therapy on body mass index and height in girls with central precocious puberty. Chonnam Med J. 2012; 48:27–31.

5. Adan L, Chemaitilly W, Trivin C, Brauner R. Factors predicting adult height in girls with idiopathic central precocious puberty: implications for treatment*. Clin Endocrinol. 2002; 56:297–302.

6. Oostdijk W, Rikken B, Schreuder S, Otten B, Odink R, Rouwe C, et al. Final height in central precocious puberty after long term treatment with a slow release GnRH agonist. Arch Dis Child. 1996; 75:292–7.

7. Greulich WW, Pyle SI. Radiographic atlas of skeletal development of hand and wrist. Redwood City (CA): Stanford University Press;1959.

8. Kim JH, Yun S, Hwang SS, Shim JO, Chae HW, Lee YJ, et al. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects. Korean J Pediatr. 2018; 61:135–49.

9. Kim YJ, Kwon A, Jung MK, Kim KE, Suh J, Chae HW, et al. Incidence and prevalence of central precocious puberty in Korea: an epidemiologic study based on a national database. J Pediatr. 2019; 208:221–8.

10. Lazar L, Padoa A, Phillip M. Growth pattern and final height after cessation of gonadotropin-suppressive therapy in girls with central sexual precocity. J Clin Endocrinol Metab. 2007; 92:3483–9.

11. Bouvattier C, Coste J, Rodrigue D, Teinturier C, Carel JC, Chaussain JL, et al. Lack of effect of GnRH agonists on final height in girls with advanced puberty: a randomized long-term pilot study. J Clin Endocrinol Metab. 1999; 84:3575–8.

12. Cassio A, Cacciari E, Balsamo A, Bal M, Tassinari D. Randomised trial of LHRH analogue treatment on final height in girls with onset of puberty aged 7.5-8.5 years. Arch Dis Child. 1999; 81:329–32.

13. Kletter GB, Kelch RP. Clinical review 60: effects of gonadotropin-releasing hormone analog therapy on adult stature in precocious puberty. J Clin Endocrinol Metab. 1994; 79:331–4.

14. Bayley N, Pinneau SR. Tables for predicting adult height from skeletal age: revised for use with the Greulich-Pyle hand standards. J Pediatr. 1952; 40:423–41.

15. Tanner JM, Whitehouse RH, Cameron N, Healy MJR, Goldstein H. Ass essment of skeletal maturity and prediction of adult height (TW3 method). 3rd ed. London: W.B. Saunders;2001.