Background: Its well known that GnRH analogue (GnRHa) could not improve the final height of mid/late pubertal girls with central precocious puberty (CPP) or early and fast puberty (EFP) for their low growth potential.
Objectives: To evaluate the effect of combined treatment with GnRHa and GH on the linear growth in mid/late pubertal girls with CPP/EFP at great bone ages. To investigate the relation between C-type natriuretic peptide (CNP) and GHs effect on their linear growth.
Methods: Twenty-two girls with CPP/EFP, whose bone ages were older than 11.5 years, received treatment of combined GnRHa with GH(GH-combined group) and GnRHa alone (control group) (n=11, respectively). Serum amino-terminal proC-type natriuretic peptide (NTproCNP), IGF1 and procollagen type 1 amino-terminal propeptide (P1NP) concentrations were measured at the beginning and end of 6 months treatment. Comparisons were made among the height velocity, increment of predicted adult height (ΔPAH) and changes of serum NTproCNP, IGF1, P1NP concentrations between the two groups.
Results: During the 6-months treatment, the height velocity (6.7±1.4 cm/year) and ΔPAH (2.4±0.8 cm) of GH-combined group were higher compared with those of control group ((4.5±0.7) cm/year, (1.0±1.1) cm, respectively, P<0.01). After 6-months treatment, serum NTproCNP, IGF1 and P1NP remained at the same level as those of beginning in GH-combined group (P>0.05). In contrast, girls in control group showed a significant decrease of serum NTproCNP ((6.9±1.5) post vs (10.5±3.6) pmol/l, pre) and P1NP, ((394.7±114.6 post vs (877.5±132.2 ng/ml pre) (P<0.05), with no significant change of IGF1.
Conclusions: Combined treatment with GnRHa and GH may accelerate linear growth and improve predicted adult height. In mid/late pubertal girls with CPP or EFP at great bone ages. This growth-accelerating effect of GH could in part be induced by increasing of CNP production.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology