Long-term observation of 87 girls with idiopathic central precocious puberty treated with gonadotropin-releasing hormone analogs: impact on adult height, body mass index, bone mineral content, and reproductive function.
OBJECTIVE
We assessed in a retrospective unicenter study the impact of treatment with GnRH analogs (GnRHa) on adult height (AH), body mass index (BMI), bone mineral density (BMD), and reproductive function in girls with idiopathic central precocious puberty (ICPP).


METHODS
Eighty-seven ICPP patients were treated with GnRHa for 4.2 +/- 1.6 yr (range 3-7.9) and observed for 9.9 +/- 2.0 yr (range 4-10.6 yr) after discontinuation of treatment; to estimate the efficacy better, 32 comparable ICPP untreated girls were analyzed.


RESULTS
AH was 159.8 +/- 5.3 cm, significantly higher than pretreatment predicted AH (PAH) either for accelerated or for average tables of Bayley and Pinneau. The gain in centimeters between pretreatment PAH and AH was 5.1 +/- 4.5 and 9.5 +/- 4.6 cm, respectively. Hormonal values and ovarian and uterine dimensions, reduced during treatment, increased to normal after 1 yr without therapy. Age of menarche was 13.6 +/- 1.1 yr with an interval of 0.9 +/- 0.4 yr after therapy. Menstrual pattern was normal. Six girls became pregnant and delivered normal offspring. BMI sd score for chronological age increased, but not significantly, before, during, and after therapy. BMD at discontinuation of treatment was significantly lower and increased to control values after gonadal activity resumption.


CONCLUSIONS
GnRHa treatment in ICPP is safe for the reproductive system, BMD, and BMI and helpful in reaching AH close to target height; however, the variability of individual responses suggests that one choose more parameters than increment in height, especially in girls with pubertal onset over 8 yr of age.
Pasquino
Anna Maria
AM
Pediatric Department, Sapienza University, Viale Regina Elena 324, 00161 Rome, Italy. annamaria.pasquino@virgilio.it
Pucarelli
Ida
I
Accardo
Fabiana
F
Demiraj
Vitan
V
Segni
Maria
M
Di Nardo
Raffaella
R
D001827:Body Height / Q000187:drug effects* / Q000502:physiology; D015992:Body Mass Index; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000502:physiology; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007986:Luteinizing Hormone / Q000097:blood / Q000502:physiology; D010053:Ovary / Q000502:physiology; D011629:Puberty, Precocious / Q000188:drug therapy* / Q000503:physiopathology*; D012098:Reproduction / Q000187:drug effects; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D017329:Triptorelin Pamoate / Q000627:therapeutic use*; D014599:Uterus / Q000502:physiology
D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone