ESPE Abstracts

Background: Girls diagnosed with central precocious puberty (CPP) or early and fast puberty (EFP) tend to exhibit temporarily rapid acceleration in growth due to increased sex hormone production or exposure, leading to premature closure of the growth plate and a shorter final adult height (FAH). Rapid progression of the secondary sexual characteristics in children can also cause poor social adaptability, psychological stress, and emotional disorders. CPP/EFP can be treated with GnRHa to halt maturation via suppression of the HPG axis. It is still a doubt that the CPP/EFP girls whether will benefit from the treatment of GnRHa combined with rhGH. However, large-scale studies to evaluate the treatment effects on FAH are still lacking.

Objective: The aimof this study was to compare the final outcomes of patients treated with GnRHa therapy with and without combined rhGH treatment, and to explore the effects of long-term treatment for CPP/EFP on FAH of its main influencing factors.

Methods: The medical records of 230 girls diagnosed with CPP/EFP from 2000 to 2020 were retrospectively reviewed at the Pediatric Department of Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University. 163 CPP girls and 67 EFP girls received GnRHa+rhGH treatment (n = 144), GnRHa alone (n = 34), no treatment (n = 20), or rhGH treatment (n = 32).

Results: We performed the final evaluations at a mean age of 14.1 ± 0.8 years after a mean treatment duration of 3.33±1.37 years. FAH in the GnRHa+rhGH group was (162±3.91) cm, significantly higher than the value of FAH in GnRHa group (160±3.02) cm (P = 0.034). The genetic height gain (FAH–Tht) was 4.45±1.87 cm for the GnRHa+rhGH group and 1.75±2.87 cm for the GnRHa group, while the control group nearly reached their Tht. FAH was significantly and positively correlated with the time of treatment, with PAHSDSTHt and with the target height, whereas the difference between chronological age at the start was negatively correlated with FAH.

Conclusion: FAH was significantly higher than the initial PAH in girls with CPP who were treated with GnRHa or combined with rhGH. The combined rhGH group had more additional height gain than the GnRHa-alone group. Age at baseline, duration of treatment, PAHSDSTHt and THt at start of treatment were correlated with FAH. GnRHa treatment was still effective even after 8 years of age in girls with CPP/EFP.