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.
|Group I (n=63)||Group II (n=72)||P|
|Cronological age (CA) (yr)||9.13±0.89||9.58±0.96||0.007|
|PH SDS- TH SDS||−0.01±1.1||0.46±1.03||0.025|
|Peak plasma LH to GnRH (mIU/mL)||14.9±17.04||5.87±7.28||0.037|
Conclusion: The patients with advanced BA and decreased PH should be evaluated in terms of treatment. Slowly progressing puberty cases do not need treatment.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology