title: Final height after combined growth hormone and GnRH analogue treatment in adopted girls with early puberty.
abstract: BACKGROUND
  Girls adopted from developing countries often have early or precocious puberty, requiring treatment with gonadotrophin-releasing hormone (GnRH) analogues. During such treatment, decreased growth velocity is frequent.
  
  
  OBJECTIVE
  To study whether the addition of growth hormone (GH) to GnRH analogue treatment improves final height in girls with early or precocious puberty.
  
  
  METHODS
  Forty-six girls with early or precocious puberty (age < or =9.5 y) adopted from developing countries were randomized for treatment for 2-4 y with GnRH analogue, or with a combination of GH and GnRH analogue.
  
  
  RESULTS
  During treatment, the mean growth velocity in the GH/GnRH analogue group was significantly higher compared to the control group. Combined GH/GnRH analogue treatment resulted in a higher final height: 158.9 cm compared to 155.8 cm in the GnRH analogue-treated group. Three out of 24 girls (13%) in the combined group and nine of the 22 girls (41%) treated with GnRH analogue alone attained a final height below -2 standard deviation scores (SDS).
  
  
  CONCLUSIONS
  The difference between the two groups is statistically significant, and possibly of clinical importance. A future challenge is to identify a subgroup with clinically significant advantage of GH addition to GnRH analogue treatment. Being very short on arrival in Sweden and being short and young at start of treatment are possible indicators.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. torsten.tuvemo@kbh.uu.se
authors.forename: T
authors.initials: T
authors.lastname: Tuvemo
authors.forename: B
authors.initials: B
authors.lastname: Jonsson
authors.forename: J
authors.initials: J
authors.lastname: Gustafsson
authors.forename: K
authors.initials: K
authors.lastname: Albertsson-Wikland
authors.forename: A S
authors.initials: AS
authors.lastname: Aronson
authors.forename: A
authors.initials: A
authors.lastname: Häger
authors.forename: S
authors.initials: S
authors.lastname: Ivarson
authors.forename: B
authors.initials: B
authors.lastname: Kriström
authors.forename: C
authors.initials: C
authors.lastname: Marcus
authors.forename: K O
authors.initials: KO
authors.lastname: Nilsson
authors.forename: U
authors.initials: U
authors.lastname: Westgren
authors.forename: O
authors.initials: O
authors.lastname: Westphal
authors.forename: J
authors.initials: J
authors.lastname: Aman
authors.forename: L A
authors.initials: LA
authors.lastname: Proos
mesh_terms: D000300:Adoption; D001827:Body Height; D002064:Buserelin / Q000627:therapeutic use*; D002648:Child; D003906:Developing Countries; D005260:Female; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D011627:Puberty / Q000502:physiology; D011629:Puberty, Precocious / Q000503:physiopathology*
chemical_list: D013006:Growth Hormone; D002064:Buserelin