ESPE Abstracts

Purpose: Both timing of menarche and growth patterns have changed with time. Menarche is supposed to important role in pediatric linear growth. This study is aimed to investigate the relationship between the timing of menarche and pubertal growth, specifically to analyze when menarche occurs related to the pubertal growth spurt, and how the pubertal height gain is related to the timing of menarche.

Method: From January 2022 to June 2022, 44 girls aged 12 to 16 years who visited the pediatrics outpatient clinics for adolescent developmental evaluation were included. Pubertal growth and predicted adult height (PAH) were analyzed before and after the timing of menarche. Eight patients were excluded by using recombinant growth hormone. The patients were divided into two groups by use of GnRH agonist or not. Among 35 patients, 27 girls (77.1%) was treated by GnRH agonist. The differences in the auxological data, menarche onset and predicted final adult height were compared using Mann-Whitney U test. Bone age was determined by the method of Greulich and Pyle. Predicted adult height was analysed by BoneXpert version 3.1 (https://bonexpert.com)

Results: Among 35 patients, adult height was reported in 6 children (17.1%) which defined as height at age ≥18 years, bone age ≥16 years, and/or a height velocity <1 cm/year. The mean menarche age with GnRH agonist was delayed (11.5 ± 1.0 vs. 12.1 ± 1.7, respectively). The mean PAH were 156.7 ± 1.8 in normal group and 160.0 ± 1.8 in GnRH agonist group before menarche. After menarche, mean PAH were 157.0 ± 0.7 in normal group and 160.5 ± 0.9 in GnRH agonist group. The pubertal height gains were more achieved in normal group 6.6 ± 3.9 vs. 4.9 ± 3.0 cm (p <0.05).

Conclusion: The mean menarche age with GnRH agonist was delayed and predicted final adult height was higher than normal group. However, the later the age of menarche, the less pubertal height gains were achieved. There is a broad variation in pubertal growth, where menarche is one important factor for different growth patterns around puberty in girls.