ESPE Abstracts

Context: Gonadotropin-releasing hormone analogues (GnRHa) and recombinant human growth hormone (rhGH) have been widely used to treat idiopathic central precocious puberty (ICPP)，yet the treatment benefit in girls between 8 and 10 years is equivocal.

Objective: This study aimto evaluate the effects of GnRHa combined with rhGH on final adult height (FAH) and to identify the factors influencing FAH.

Methods: In a retrospective study, children with ICPP (60 girls) that reached FAH were included. They were divided into GnRHa combined with rhGH treatment(n = 30) and GnRHa alone(n = 30), according to whether they combined with growth hormone or not. Bone age (BA)/ chronological age (CA), growth velocity (GV), predicted adult height (PAH), FAH, height gain, height standard deviation score (HtSDSBA) and duration of medication were analyzed.

Results: When GnRHa was discontinued after drug treatment, BA/CA was further reduced compared with that before treatment (Z=-6.736, P < 0.001), and the second annual growth rate growth velocity of GnRHa and GnRHa+rhGH groups were lower than that of the first year growth velocity (t=4.103, P < 0.001), (t=2.777, P < 0.022), the height benefit of GnRHa+rhGH group was 8.13±3.46cm better than that of GnRHa group 4.72±3.05cm (t=4.056, P < 0.001). Linear regression analysis with height benefit as the dependent variable showed that PAH before treatment (β=-0.674, t=-8.713, P < 0.001) and HtSDSBA level after treatment (β=4.362, t=6.223, P < 0.001) were independent influencing factors of height benefit. The lower the PAH level before treatment and the higher the HtSDSBA after treatment, the greater the height benefit.

Conclusion: GnRHa combined with rhGH therapy or GnRHa therapy improved adult height in girls with ICCP, but the combination therapy had better benefits for height, and GnRHa and rhGH therapy may be preferred in girls with severe PAH impairment.