ESPE Abstracts

Purpose: To describe and analyze association between early-puberty girls’ bone maturation and linear growth in Shenzhen City.

Methods: Girls diagnosed as "Early-onset puberty" without drug intervention were collected from Shenzhen Children's Hospital From January 2016 to December 2020. Artificial intelligence (AI) system was used to evaluate bone age. The girls were divided into groups according to age and bone age, △BA/△CA and the progress of height SDS were described and analyzed respectively. LMS Chartmaker method was used to draw percentile curves to describe pattern of bone maturation and linear growth.

Results: A total of 498 girls were included in the study. The average age of initiation of breast development was 8.1±0.5 years old. LMS method was used to construct growth curves along with EP girls' bone age and chronological age seperately, and were compared with normal girls’. As for growth curve along with bone age, it showed a pattern of attenuation growth from 7 to 9 years old and showed a turning point of upward catch-up growth at 11 years old, the linear growth curve of EP girls approached to the normal growth curve after 11. The bone age of peak height velocity was between 11.5 and 12.0 years old. Meanwhile, Nearly half of the patients reached to significant rapid progress of bone age over chronological age (median of △BA/△CA > 2) before bone age 8 years old. But the progression of bone age over age showed a trend of slowing down. As for growth along with Chronological age, it showed a similar pattern as normal girls’ from 7 to 10 years old. The average height of EP girls were taller than normal girls, but the difference started to narrow down after 10 years old.△BA/△CA declined slightly along with chronological age.

Conclusions: Girls of early-onset puberty have their own pattern of growth and bone maturation. At bone age from 7 to 11 years old, the rate of bone maturation was faster and the growth of height was attenuated with the increase of bone age. After 11 years of bone age, with the increase of bone age, the progress of bone maturation slowed down, and the height began to catch up and approached to the normal growth curve.