Factors determining normal adult height in girls with gonadotropin-dependent precocious puberty treated with depot gonadotropin-releasing hormone analogs

Vinicius Nahime Brito, Ana Claudia Latronico, Priscilla Cukier, Milena Gurgel Teles, Letícia F G Silveira, Ivo Jorge Prado Arnhold, Berenice Bilharinho Mendonca
Journal of Clinical Endocrinology and Metabolism 2008, 93 (7): 2662-9

CONTEXT: Several factors can affect adult height (AH) of patients with gonadotropin-dependent precocious puberty (GDPP) treated with depot GnRH analogs.

OBJECTIVE: Our objective was to determine factors influencing AH in patients with GDPP treated with depot GnRH analogs.

PATIENTS: A total of 54 patients (45 girls) with GDPP treated with depot GnRH analog who reached AH was included in the study.

DESIGN: Univariate and multivariate analyses of the factors potentially associated with AH were performed in all girls with GDPP. In addition, clinical features of the girls who attained target height (TH) range were compared with those who did not. Predicted height using Bayley and Pinneau tables was compared with attained AH.

RESULTS: In girls the mean AH was 155.3 +/- 6.9 cm (-1.2 +/- 1 sd) with TH range achieved by 81% of this group. Multiple regression analysis revealed that the interval between chronological age at onset of puberty and at the start of GnRH analog therapy, height sd scores (SDSs) at the start and end of therapy, and TH explained 74% of AH variance. The predicted height at interruption of GnRH therapy, obtained from Bayley and Pinneau tables for average bone age, was more accurate than for advanced bone age in both sexes. In boys the mean AH was 170.6 +/- 9.2 cm (-1 +/- 1.3 SDS), whereas TH was achieved by 89% of this group.

CONCLUSIONS: The major factors determining normal AH in girls with GDPP treated with depot GnRH analogs were shorter interval between the onset of puberty and start of therapy, higher height SDS at the start and end of therapy, and TH. Therefore, prompt depot GnRH analog therapy in properly selected patients with GDPP is critical to obtain normal AH.

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