Background: The use of GnRHa in central precocious puberty is known to slow puberty progression, subsequently prevent early menarche, and attenuate the height loss by advanced skeletal maturation. But enhancing the final height was so controversial that an additional approach has been used.
Objective and hypotheses: To investigate the age of menarche, and the height outcomes in central precocious girls treated with GnRHa (n=61) or combined GH (n=24).
Method: GnRHa was started at 8.1±0.7 years for 2.1±1.0 years. GH was used for subjects with short predicted adult height (PAH) for 2.1±1.1 years.
Results: Menarche occurred at 11.6±0.8 years after 15.7±6.4 months of GnRHa discontinuation. PAH increased significantly from 152.0±7.2 to 158.8±5.6 cm during treatment, and near final height (NFH) was 159.7±4.8 cm, taller than mid-parental height of 157.8±3.4 cm. The combined treatment group showed greater height increment during treatment. Younger age, taller height at the start of treatment, taller parental height, and longer duration of treatment were the factors influencing NFH.
Conclusion: Long-term GnRHa treatment in central precocious girls could improve NFH, and delay menarche to become close to those of the general population. If combined GH is used in precocious girls with short mid-parental height, it would improve NFH to become similar to the general population.
Funding: This work was supported by a research grant from Chungbuk National University in 2013.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology