ESPE Abstracts

Background: Central precocious puberty (CPP) and early puberty (EP) are characterized by premature breast development. Girls with CPP and EP who experience rapid pubertal progression are treated with gonadotropin-releasing hormone analog (GnRHa) to halt pubertal advancement and optimize height potential. However, studies on factors impacting near-final height (NFH) for CPP and EP in Asian girls remain scarce. We aim ed to explore the factors associated with predicting normal NFH in girls with CPP and EP following GnRHa treatment.

Methods: A retrospective study was conducted on girls diagnosed with CPP or EP, who underwent treatment with GnRHa and achieved NFH (height gain below 2 cm/year) between 2007 and 2023. Patients were categorized into normal NFH and impaired NFH groups based on their NFH outcomes. Normal NFH is defined as a difference between NFH and target height (TH) of 3 cm or less. Complete-case analysis was conducted and predictive factors contributing to the attainment of normal NFH were identified.

Results: There were 279 patients initially enrolled and 233 girls (214 diagnosed with CPP) were included in the analysis. The mean age at onset of puberty was 7.1 years, while the mean age at diagnosis and commencement of treatment were 8.4 years. Most of the girls (71%, 168 girls) present with breast development, while 27% (63 girls) present with menstruation. On average, patients underwent GnRHa treatment for 2.1 years and achieved NFH at the age of 13.8 years. A total of 188 (81%) girls attained normal NFH, exceeding their TH by 2.8 (0, 5.8) cm. Notably, patients who were taller and had higher predicted adult height (PAH) at diagnosis demonstrated a higher probability of achieving normal NFH (risk ratio (RR) 1.02, P = 0.001, and 1.02, P = 0.013, respectively). Intriguingly, treatment initiation at a later age was associated with lower chance of attaining normal NFH (RR 0.85, P = 0.002). Regarding predictors at the cessation of treatment, girls with higher stature and a longer treatment duration were more likely to achieve normal NFH (RR 1.05, P <0.001, and 1.14, P = 0.002, respectively).

Conclusion: Patients with higher PAH and taller stature at diagnosis, as well as higher height at cessation of treatment and longer treatment duration, were more likely to achieve normal NFH. Conversely, patients with initiation of treatment at a later age were less likely to achieve normal NFH. This knowledge may guide appropriate treatment for girls with CPP and EP, extending beyond the consideration of skeletal maturation.