ESPE Abstracts (2016) 86 P-P2-775

Effect of Gonadotropin Releasing Hormone Analogues (GnRHa) on Final Height in Girls with Borderline Early Puberty or Normal Physiological Puberty Depend on Bone Age Advancement and Predicted Height

Zeynep Hizli, Firdevs Bas, Sukran Poyrazoglu, Mikail Genens, Zehra Yavas Abali, Ruveyde Bundak & Feyza Darendeliler


Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey


Background: Borderline precocious and normal-onset puberty can show slow or fast course. The fast development of pubertal signs can be resulted in decrease in final height (FH) via accelerated growth and bone maturation.

Objective and hypotheses: To study the effectiveness of GnRHa in improving FH in girls with advanced bone age (BA) and decreased predicted height (PH) in borderline early or normal physiological puberty.

Method: 135 girls whose puberty started between 6.83 and 9.73 years (yr) were divided into two groups according to BA advancement and decreased PH after 7.28±8.88 months of follow up after the onset of puberty: group I with low PH was treated with GnRHa for 2.22±0.85 year, group II with normal PH was followed without treatment.

Results: Values between the groups were compared at the onset of therapy in group I and at respective time in group II. The results are shown in the Table 1. GnRHa delayed sexual maturation as well as BA and cause increased PH in group I. 87.3% of patients in group I and % 86.5 of girls in group II achieved their FH within their target height (TH) range (TH-1 SDS). Stepwise linear multiple regression analysis for both groups showed that height gain was mainly affected by BA and PH at the start of treatment. Basal LH level also was a contributing factor.

Table 1.
Group I (n=63)Group II (n=72)P
Cronological age (CA) (yr)9.13±0.899.58±0.960.007
BA (yr)11.12±1.0610.27±1.760.003
Height SDS0.86±1.320.61±1.090.240
BMI SDS0.8±1.070.76±0.960.840
ΔBA/ΔCA1.97±1.291.07±1.310.003
PH SDS−1.1±1.29−0.38±1.030.002
TH (cm)156.9±5.42158.17±4.750.147
PH SDS- TH SDS−0.01±1.10.46±1.030.025
LH (mIU/mL)2.31±2.281.09±1.50.038
FSH (mIU/mL)4.1±2.133.66±2.710.496
Peak plasma LH to GnRH (mIU/mL)14.9±17.045.87±7.280.037

Conclusion: The patients with advanced BA and decreased PH should be evaluated in terms of treatment. Slowly progressing puberty cases do not need treatment.