Abstract
ObjectiveGonadotropin-releasing hormone agonist (GnRHa) treatment improves the potential for gaining height in patients with central precocious puberty (CPP). However, most studies have focused on girls because CPP in boys is relatively rare. Therefore, we aimed to determine the effect of GnRHa treatment on auxological outcomes in boys with CPP.MethodsEighty-five boys with CPP were treated with leuprolide or triptorelin acetate 3.75 mg over 2 years. Anthropometry, bone age, sexual maturity rating, and predicted adult height (PAH) were assessed every 6 months. Furthermore, 20 boys were followed up after treatment discontinuation until achievement of the final adult height (FAH).ResultsThe mean chronological age (CA) and bone age (BA) of the patients with CPP at treatment initiation were 9.5 ± 0.5 years and 11.7 ± 0.9 years, respectively. The mean duration of treatment was 2.87 ± 0.63 years. The PAH at treatment initiation was 172.1 cm (-0.23 ± 1.05 PAH standard deviation score). The PAH at treatment discontinuation (176.2 ± 6.6 cm) was significantly higher than the pretreatment PAH. In addition, the mean final adult height in the 20 boys who were followed up after discontinuation of treatment was 173.4 ± 5.8 cm, which was significantly higher than the initial PAH (170.1 ± 4.5 cm; p = 0.006). In multivariate analysis, the height gain (the difference between the FAH and PAH at treatment initiation) significantly correlated with the target height.ConclusionLong-term GnRHa treatment significantly improved the growth potential and FAH in boys with CPP.
Highlights
Precocious puberty (PP) refers to the development of secondary sexual characteristics before the age of 8 and 9 years in girls and boys, respectively [1]
The mean final adult height in the 20 boys who were followed up after discontinuation of treatment was 173.4 ± 5.8 cm, which was significantly higher than the initial predicted adult height (PAH) (170.1 ± 4.5 cm; p = 0.006)
The height gain significantly correlated with the target height
Summary
Precocious puberty (PP) refers to the development of secondary sexual characteristics before the age of 8 and 9 years in girls and boys, respectively [1]. Central precocious puberty (CPP) is caused by early maturation of the hypothalamic–pituitary–gonadal axis. It is caused by organic brain disorders such as tumors, hemorrhage, or infection in approximately 40%–50% boys with CPP [1]. The main goal of treatment for CPP is to suppress the gonadal sex steroid secretion effectively to stop premature sexual maturation. The treatment aims to preserve the potential to achieve acceptable adult height in each individual based on genetic determinants by suppressing the accelerated skeletal advancement [1]
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