Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis, affecting approximately 2 to 4 percent of adolescents. AIS by definition occurs in children between 10 to 18 years old, in periods of growth spurts and puberty changes. In patients with central precocious puberty (CPP), generally, growth spurts start earlier than their peers. Therefore, AIS in patients with CPP is expected to develop earlier in juvenile age. Especially in girls, both AIS and CPP are more common than boys thus the risk of AIS may be higher in girls with CPP. The purpose of this study was to determine the incidence of idiopathic scoliosis in girls with central precocious puberty and evaluate an influence of gonadotropin-releasing hormone (GnRH) agonists treatment for CPP patients to prevent progression of scoliosis.
Medical records of 655 girls, 338 with central precocious puberty and 317 for control, in three branches of Korea University Medical Centers pediatric endocrinology clinic from March 2014 to September 2018 were retrospectively reviewed. The angle of scoliosis was measured on the standing frontal radiograph of each patients according to the Cobb method and a curve with a Cobb angle of 10 degrees or more is defined scoliosis. For CPP girls, follow up spine radiographs were taken after 1-year of GnRH agonists treatment, Cobb angles were measured and follow up Cobb angles were compared with initially measured Cobb angles.
An incidence rate of idiopathic scoliosis is 9.3% in total; central precocious puberty girls had a higher incidence (11.5%) than control (6.9%) and statistically significant (P=0.043). LH peak level correlated with Cobb angle and it is statistically significant (R2=0.014, P=0.027). No progression of scoliosis was showed in central precocious puberty girls after 1year of GnRH agonist treatment.
The incidence of idiopathic scoliosis is higher in girls with central precocious puberty. GnRH agonist treatment for CPP may have a preventive effect on AIS. Further longitudinal study regarding the effects of GnRH agonists treatment for patients of scoliosis with central precocious puberty is needed.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology