title: Benefit of postponing normal puberty for improving final height.
abstract: Experiments of nature and clinical observations have provided indications that postponing puberty may increase final height in short children. In children with central precocious puberty, a GnRH analog (GnRHa) alone is efficacious in increasing final height, but in other conditions a combination of growth hormone (GH) and GnRHa is needed. In GH-deficient children with early onset of puberty and poor height prediction, the combination of GH and GnRHa increases final height by 1.0-1.3 s.d. In children with idiopathic short stature and persistent short stature after intrauterine growth retardation, the combination also appears to be beneficial. Potential side effects include weight gain, a negative effect on bone mineralization, and psychosocial consequences. More data on long-term safety have to be collected before the combination of GH and GnRHa in children with idiopathic short stature should be considered for clinical use outside clinical trials.
authors.affiliation: Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. j.m.wit@lumc.nl
authors.forename: J M
authors.initials: JM
authors.lastname: Wit
authors.forename: H Visser-Van
authors.initials: HV
authors.lastname: Balen
authors.forename: G A
authors.initials: GA
authors.lastname: Kamp
authors.forename: W
authors.initials: W
authors.lastname: Oostdijk
mesh_terms: D000223:Adaptation, Psychological / Q000187:drug effects; D001827:Body Height; D001835:Body Weight / Q000187:drug effects; D002113:Calcification, Physiologic / Q000187:drug effects; D002648:Child; D004359:Drug Therapy, Combination; D005317:Fetal Growth Retardation / Q000188:drug therapy; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D011627:Puberty; D011629:Puberty, Precocious / Q000188:drug therapy; D015430:Weight Gain
chemical_list: D019382:Human Growth Hormone; D007987:Gonadotropin-Releasing Hormone; C083781:LHRH, Ala(6)-Gly(10)-ethylamide-