Comparing adult height gain and menarcheal age between girls with central precocious puberty treated with gonadotropin-releasing hormone agonist alone and those treated with combined growth hormone therapy

Abstract

Purpose This study aimed to investigate the outcomes of gonadotropin-releasing hormone agonist (GnRHa) therapy with or without growth hormone (GH) therapy for girls with idiopathic central precocious puberty (CPP). Methods The medical records of 166 girls diagnosed with CPP from 2002 to 2017 were retrospectively reviewed. All included patients were treated with GnRHa for ≥36 months. Changes in height standard deviation score (SDS) for bone age, chronological age (CA), and predicted adult height (PAH) were assessed for the first three years of treatment. The final height gain SDS was calculated as the difference between the initial PAH SDS and adult height (AH) SDS; these were then compared between the GnRHa group (group A, n=135) and the combined GnRHa/GH group (group B, n=31). Results The initial mean CA was 7.89 years. The mean menarcheal age was 13.12 years (group A, 13.1±0.99; group B, 13.18±0.58 years; P =0.755). PAH SDS at the start of GnRHa treatment and AH SDS were significantly lower in group B than in group A (PAH SDS: -2.20±0.83 vs. -3.19±0.84, P <0.001; AH SDS: 0.18±084 vs. -0.30±0.66, P =0.021). The increase in PAH SDS was higher in group B than in group A for the first three years of GnRHa treatment (1.66±0.66 vs. 2.35±0.93, P <0.001). The height gain SDS was significantly higher in group B than in group A (2.5±0.75 vs. 2.93±1.02, P =0.048). Younger age, higher PAH at the start of treatment, and a greater increase in PAH SDS during the first year of GnRHa treatment positively affected AH. Conclusions The combined GH group had more additional height gain than the GnRHa-alone group.

GnRHa/Stanozolol Combined Therapy Maintains Normal Bone Growth in Central Precocious Puberty

“…Thus, an agent which can diminish the side effects of GnRHa and maintain normal growth plate development would theoretically be of great benefit for the treatment of CPP. Previous studies have reported the positive effects of GH administration on height in patients with CPP and showed that the combined use of GH and GnRHa is effective in preventing a decline in growth rate (26)(27)(28). However, GH is an expensive medicine and difficult to use in conventional treatment.…”

“…Castro et al. report that ST has chondroprotective effects in OA ( 28 ). In the latter study, ST treatment reduced the expression of several pro-inflammatory cytokines (MMP1, IL-6, and COX-2) in both normal and inflammatory chondrocytes to prevent the degeneration of cartilage.…”

Association of Early Pubertal Onset in Female Rats With Inhalation of Lavender Oil

“… 2 3 Improving the final adult height of children with CPP is one of the major issues during treatment. 5 6 However, the incidence of precocious puberty is rapidly increasing, and examination and treatment of this condition are becoming a major burden because of the associated medical expenses, although the cause of this condition remains unknown. 2 3…”

Association of Early Pubertal Onset in Female Rats with Inhalation of Lavender Oil

“…CPP treatment was introduced in 1980, and dosing of a recombinant GnRH agonist every 4 weeks or 3 months leads to increases in the nal adult height and delayed menarche (2,3). Improving the nal adult height of children with CPP is one of the major issues during treatment (5,6). However, the incidence of precocious puberty is rapidly increasing, and examination and treatment of this condition are becoming a major burden because of the associated medical expenses, although the cause this condition remains unknown (2,3).…”