Background: Studies evaluating the gain in final height in patients with idiopathic central precocious puberty (ICPP) report variable outcomes and mostly lack comparison with untreated controls.
Objective and hypotheses: To compare the final height of ICPP patients treated with GnRH analog with and untreated control group.
Method: 48 girls with ICPP treated with GnRH analog and 52 untreated girls with ICCP (due to late referral or refusal of treatment) formed study groups and followed to adult height (min. 2 years after menarche)
Results: The mean age at referral and treatment was 7.76±1.24 and 8.08±0.85 years respectively. The difference between chronological age and bone age at the start of treatment was 1.9±1.18 years. Mean PAH at the beginning of treatment was 154.6 cm. There was a 5.6 cm gain at final height with respect to PAH at the beginning of treatment. Treatment group exceeded MPH by 1.6 cm whereas control group remained 1.9 cm below MPH. (total difference is 3.5 cm). Treatment duration was 2.7±0.89 years. The time interval from the end of treatment to the menarche was 1.3±0.74 years. Height gain from the end of treatment to final height was 12.2±3.3 cm. Height gain from the beginning of treatment to final height was 26.9±6.8 cm. BMI SDS at the beginning and end of treatment was 0.99±0.90 and 0.90±075 respectively (P: NS) (Table 1).
|Treatment group (n: 48)||Control group (n: 52)||P|
|Final height cm (SDS)||160.6 (0.10)||158.1 (0.33)||0.026 (0.042)|
|MPH, cm (SDS)||159 (−0.23)||160 (0.00)||0.239 (0.226)|
|Final-MPH, cm (SDS)||1.05 (0.17)||−2.01 (−0.34)||0.026 (0.03)|
|Age at menarche (years)||12.1±0.9||10.0±0.6||<0.001|
|Maternal age of menarche (years)||13.0±1.4||12.6±1.7||0.182|
Conclusion: Treated patients exceeded their MPH by 1.05 cm whereas untreated patients remained −2.01 cm below their MPH which corresponds to a total gain of 3.06 cm. This means a gain of 1.13 cm/treatment year. Thus the younger the patient, the more is the height benefit with treatment. This modest effect is without detrimental effect on BMI.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology