title: Adult height after spontaneous pubertal growth or GnRH analog treatment in girls with early puberty: a meta-analysis.
abstract: Early puberty (EP) has been defined as the onset of puberty in the low-normal range; it may be a cause for concern regarding a possible impairment of adult height (AH). This paper meta-analysed data on AH after spontaneous growth or after gonadotropin-releasing hormone (GnRH) analog treatment in girls with EP. A computerized literature search was conducted from 1980 to June 30, 2016. Only published studies in English were considered. Eight papers were selected (483 cases). In untreated girls (n = 300), predicted adult height (PAH) at start of follow-up (-0.559 SDS (95%CI -1.110 to 0.001); P = 0.050) was close to mid-parental height (MPH) (-0.557 SDS (95%CI -0.736 to -0.419); P < 0.0001) and AH (-0.663 SDS (95%CI -0.803 to -0.524); P < 0.0001). In GnRH analog treated girls (n = 183), PAH before the start of treatment was slightly reduced (-0.939 SDS (95%CI -1.401 to -0.477; P < 0.0001) vs MPH (-0.678 SDS (95%CI -0.942 to -0.414); P < 0.0000), but AH (-0.604 SDS (95%CI -0.877 to -0.338); P < 0.0000) was close to MPH.
  
  
  CONCLUSIONS
  Present meta-analysis indicates that girls with EP spontaneously reach their MPH and that GnRH analog treatment does not widely change growth outcome. Differences among the selected studies for definition of EP, inclusion criteria, treatment duration, age at discontinuation of therapy, definition of AH may affect results. What is Known: • Early puberty represents a main cause of consultation in paediatric endocrinology offices due to concerns of both practitioners and parents. • Treatment with GnRH analogs is sometimes attempted with the aim to improve adult height. What is New: • Untreated and GnRH analog treated girls with early puberty reached similar adult height. • Adult height was consistent with mid-parental height in both untreated and GnRH analog treated girls with early puberty.
authors.affiliation: Pediatric Division, Department of Obstetrics, Gynecology and Pediatrics, St. Chiara University Hospital of Pisa, Via Roma 67, 56126, Pisa, Italy. s.bertelloni@ao-pisa.toscana.it.
authors.forename: Silvano
authors.identifier: http://orcid.org/0000-0003-1264-3284
authors.initials: S
authors.lastname: Bertelloni
authors.affiliation: Pediatric Division, Department of Obstetrics, Gynecology and Pediatrics, St. Chiara University Hospital of Pisa, Via Roma 67, 56126, Pisa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Massart
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Miccoli
authors.affiliation: Pediatric Division, Department of Obstetrics, Gynecology and Pediatrics, St. Chiara University Hospital of Pisa, Via Roma 67, 56126, Pisa, Italy.
authors.forename: Giampiero I
authors.initials: GI
authors.lastname: Baroncelli
mesh_terms: D000328:Adult; D001827:Body Height / Q000187:drug effects*; D002648:Child; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D011629:Puberty, Precocious / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D007987:Gonadotropin-Releasing Hormone
keywords: Adult height; Early puberty; Girls; GnRH analog; Meta-analysis; Safety