Growth response during GnRH-A treatment in patients with precocious puberty

Abstract

Aim: To analyze the height gain in children with precocious puberty who have been treated with GnRH-A for at least three years. Method and Materials: 18 patients (16 girls and 2 boys) with isosexual complete precocious puberty were included in the current study. Diagnosis was documented by LHRH stimulation test plus sex steroid assays. The mean age at onset of treatment was 6 years (SD = 2.41) and skeletal maturation was advanced (mean = 8.67, SD = 2.77 years). Hormonal profiles and skeletal maturation were monitored throughout the treatment course. Results: The mean height SDS for age during the first 3 years of treatment followed the prepubertal reference values, but the height SDS based on skeletal maturation at the onset of treatment improved by 0.9 SDS during the three years of treatment (p<0.01). In a multiple regression analysis, height SDS and the advancement of skeletal maturation at the onset of treatment explained 41% of the growth response in the first 3 years. Neither the age at onset of treatment nor the midparental height improved the fit of the multiple regression By including the gain in skeletal maturation during the three treatment years a total of 77% of the variation in growth was explained Conclusion: (1) GnRH-A has a beneficial effect on height prognosis in children with precocious puberty during the early years of treatment. (2) Height gain during the early treatment years can be partially predicted by the height SDS and skeletal age advancement at the onset of treatment.