ESPE Abstracts

Introduction: Early and fast puberty (EFP) in girls, defined as pubertal onset at age 8-9 yr., with an accelerated course, may cause compromised final adult height (FAHt). Treatment with a gonadotropin-suppressive agent is still controversial because the improvement in FAHt is equivocal and there may be a risk of overweight.

Aim of the study: We analyzed the data of 24 girls with EFP treated with GnRH analog (GnRH) since Tanner stage 2-3, for 3 yr; and measured their clinical, hormonal and skeletal maturation for the period of treatment.

Results: Before GnRH therapy their (age = 7.5 +/- 1.8 y) their HtSDS = 0.75 +-1 and their bone age was advanced by 2 +/-1 yr. compared to their chronological age. The difference between their HtSDS and their mid-parental HtSDS (MPhtSDS) = 1.5 +/- 0.9. After 3 years of using GnRH 3.75 mg IM monthly, (age = 10.9 +/- 1.5 yr.) their HtSDS = 0.43 +/- -1.6 and their bone age advanced by 0.8 +/-1 yr. compared to their chronological age. The difference between their HtSDS and their MPhtSDS = 1.1 +/- 1.3. Their breast Tanner stage was similar to that at the beginning of therapy. The BMI SDS increased from 1.25 +/- 1 before treatment to 1.65 +/- 1 after 3 years of treatment.

Conclusion: GnRH therapy for 3 years was successful in delaying the onset of a pubertal growth spurt, decreasing the rapid progress of their skeletal maturation, and increasing the potential for attaining final adult height comparable to or higher than their mid parental height. The treatment was associated with a mild increase in the BMI SDS.