Object: To assess the efficacy and impact factors of treatment with GnRHa alone or in combination with rhGH in idiopathic central precocious puberty (CPP) or early and fast puberty (EFP) in Chinese girls.
Methods: We conducted a retrospective analysis on 20 years of data obtained from 11 medical centers from January 1998 to March 2017, and 393 girls with CPP (n=302) or EFP (n=91), who untreated or received GnRHa alone or in Combination with rhGH therapy for more than six months and reached their adult height were enrolled. Another group of 55 patients is from our hospital, and their medical records were reviewed as an independent dataset, including 31 CPP and 24 EFP patients.We evaluated age, height, weight, and bone age (BA) before and after treatment,the final adult height was recorded for each patient. During treatment, the dosage of medication was recorded.
Results: We calculated the difference between height gain (FAH-PAH1) [GnRHa+rhGH & GnRHa & control group: (9.51±0.53) & (8.07±0.37) & (6.44±0.91), P<0.05], the difference between delta genetic height (FAH-genetic height)[GnRHa+rhGH & GnRHa & control group: (4±0.5) & (2±0.27) & (0±0.61), P<0.01], and the difference of predictive adult heights before and after treatment (PAH2-PAH1). In GnRHa group, the ROC curve analysis of each parameter indicated that five different ones (PAHSDS, PAH1, Height1/BH1, HA/BA1, and PAH2-PAH1) had excellent performance of diagnosing patients whether they received good therapeutic results from GnRHa treatment or not. In GnRHa+rhGH group, the ROC curve analysis and identified another five clinical parameters (PAH2-PAH1, Height1/BH1, PAH1, PAHSDS, HA/BA1) had excellent performance of diagnosing patients whether they may receive good therapeutic results.
Conclusions: Therapy to CPP or EFP girls can effectively improve the height gain (FAH-PAH1), especially in the GnRHa+rhGH treatment. HA/BA is an important factor affecting the long-term efficacy of CPP/EFP. Clinicians should pay attention to it.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology