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Which parameters predict the beneficial effect of GnRHa treatment on height in girls with central precocious puberty?

Abstract：

OBJECTIVE:Data about GnRHa on adult height in girls with central precocious puberty(CPP) have shown variable results, ranging from improvement of growth prognosis to lack of any benefit.This study was designed to delineate the criteria to decide which girls with idiopathic CPP(iCPP) will have a height benefit from GnRHa treatment. DESIGN:Retrospective PATIENTS: 102 girls with iCPP who had reached final height(FH) were included. MEASUREMENTS:Auxological, hormonal, and radiological findings at treatment onset, and FHs were extracted from records. RESULTS:Most important factor affecting height gain was chronological age(CA) at treatment onset.All the girls treated ≤6.4 years of age achieved a height gain ≥1SDS while none of the girls treated ≥8.3 years of age made the target. 75.6% of patients who started GnRHa between the ages of 6.4-8.3 years had a height gain of ≥1SDS.Most important factors affecting height gain in those treated 6.4-8.3 years were advanced bone age(BA), basal estradiol(E2 ) and pubertal stage(r2 :0.906;p<0.001).All individuals with BA advancement of ≥2.6 years or E2 of ≥32.6pg/ml or pubertal stage of ≥3 had significant height gain, none of the cases with BA advancement <2 years or E2 of <21.5pg/ml or pubertal stage of <2 had a height gain ≥1SDS. CONCLUSIONS:Treatment with GnRHa is unquestionably beneficial to improve FH in girls with iCPP when initiated ≤6.4 years of age.GnRHa treatment after 8.3 years of age may not improve FH.Girls between the ages of 6.4-8.3 years at presentation can have a better height gain if BA (≥2.6 years over CA) and pubertal findings (pubertal stage≥3, or E2 ≥32.6pg/ml) are well-advanced.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Vuralli D,Gonc EN,Ozon ZA,Kandemir N,Alikasifoglu A

doi

10.1111/cen.14420

subject

Has Abstract

pub_date

2021-01-18 00:00:00

eissn

0300-0664

issn

1365-2265

pub_type

杂志文章

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