ESPE Abstracts

Introduction: Our study aimed to describe the clinical profile of children with central precocious puberty (CPP) presenting to a single tertiary centre, and to determine the factors that would lead patients and families to pursue treatment with gonadotrophin releasing hormone (GnRH) agonist as well as the predictors of a more favourable final adult height in this cohort.

Methods: We conducted a retrospective medical chart review of all children (n= 203) with CPP at a single paediatric tertiary hospital from 1st January 2013 to 31st August 2021. Multivariable logistic and linear regressions were used to predict the use of GnRH-agonist treatment and determine predictors of final adult height respectively.

Results: A total of 203 patients confirmed to have CPP were included in this study, with a female predominance (96.1%). The mean chronological age at presentation was 7.54 ±1.31 years in girls (n= 195) and 9.86 ± 0.63 years in boys (n= 8). The mean bone age at diagnosis was 12.6 ± 0.71 years in girls and 9.62 ± 2.11 years in boys. Majority of the patients presented in Tanner Stage 3 of puberty. All of the children in the study were taller and heavier than their peers, with mean height SDS at presentation of 1.31 ± 1.12 and mean weight SDS at presentation of 1.05 ± 0.94. One-hundred and one patient received GnRH agonist treatment, with only 1 patient receiving combination therapy of GnRH agonist and growth hormone. At the end of the study period, only 41 patients with CPP completed their GnRH agonist treatment and had reached their final adult height. Compared to baseline, the mean gain of height standard deviation score (SDS) was 0.02 ± 0.87 suggesting that while GnRH agonist treatments did not significantly augment final adult height, it appeared at least to preserve the height SDS at final height. Predicted final adult height appeared to be a significant predictor of being on GnRH-agonist treatment with odds ratio 0.863 (95% CI 0.749 – 0.994, P-value=0.04). The strongest predictors for final adult height in those who had received GnRH-agonist treatment were age (beta-coefficient -3.63, 95% CI -6.10 – -1.17, P-value=0.006) and height at presentation (beta-coefficient of 0.894 (95% CI 0.465 – 1.324, P-value<0.005) respectively.

Conclusions: In our centre, while GnRH-agonist treatments did not significantly augment final adult height, it appeared at least to preserve the height SDS at final height. Age and height at presentation were significant predictors of final height in those who received treatment.