Considerations on the improvement of height benefit in children with central precocious puberty
LIANG Li-Yang
Department of Pediatric Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China (Email: liangliy@mail.sysu.edu.cn)
Abstract：With the changes in various factors such as genetics and the environment, the incidence of childhood precocious puberty has been gradually increasing. Improving height is one of the key issues in the clinical management of precocious puberty. Currently, gonadotropin-releasing hormone analogs (GnRHa) remain the preferred treatment for precocious puberty, but their effect on height improvement is influenced by multiple factors, which may result in lower-than-expected height benefits. Combining recombinant human growth hormone (rhGH) therapy with GnRHa treatment is an alternative strategy to enhance the efficacy of GnRHa, but there is still no clear recommendation regarding the timing of their combination. Considering the current status of precocious puberty treatment, it is crucial to reevaluate the effects of GnRHa monotherapy and combination therapy with rhGH on height improvement. This article discusses strategies such as combination therapy indications to guide clinical medication and help children with precocious puberty achieve optimal height benefits.
Liu M, Cao B, Luo Q, et al. The critical BMI hypothesis for puberty initiation and the gender prevalence difference: evidence from an epidemiological survey in Beijing, China[J]. Front Endocrinol (Lausanne), 2022, 13: 1009133. PMID: 36387887. PMCID: PMC9641365. DOI: 10.3389/fendo.2022.1009133.
De Sanctis V, Soliman AT, Di Maio S, et al. Long-term effects and significant adverse drug reactions (ADRs) associated with the use of gonadotropin-releasing hormone analogs (GnRHa) for central precocious puberty: a brief review of literature[J]. Acta Biomed, 2019, 90(3): 345-359. PMID: 31580327. PMCID: PMC7233750. DOI: 10.23750/abm.v90i3.8736.
Shi Y, Ma Z, Yang X, et al. Gonadotropin-releasing hormone analogue and recombinant human growth hormone treatment for idiopathic central precocious puberty in girls[J]. Front Endocrinol (Lausanne), 2022, 13: 1085385. PMID: 36589818. PMCID: PMC9794601. DOI: 10.3389/fendo.2022.1085385.
Cho AY, Shim YS, Lee HS, et al. Effect of gonadotropin-releasing hormone agonist monotherapy and combination therapy with growth hormone on final adult height in girls with central precocious puberty[J]. Sci Rep, 2023, 13(1): 1264. PMID: 36690835. PMCID: PMC9870989. DOI: 10.1038/s41598-023-28602-3.
Ni MM, Yang ST, Wu WW, et al. Benefits from the first year of GnRHa therapy in boys with idiopathic central precocious puberty when initiating treatment after age 9 years: findings from a real-world retrospective study[J]. BMC Endocr Disord, 2022, 22(1): 299. PMID: 36456936. PMCID: PMC9716691. DOI: 10.1186/s12902-022-01207-z.
Bangalore Krishna K, Fuqua JS, Rogol AD, et al. Use of gonadotropin-releasing hormone analogs in children: update by an international consortium[J]. Horm Res Paediatr, 2019, 91(6): 357-372. PMID: 31319416. DOI: 10.1159/000501336.
Baek JW, Nam HK, Jin D, et al. Age of menarche and near adult height after long-term gonadotropin-releasing hormone agonist treatment in girls with central precocious puberty[J]. Ann Pediatr Endocrinol Metab, 2014, 19(1): 27-31. PMID: 24926460. PMCID: PMC4049550. DOI: 10.6065/apem.2014.19.1.27.
Lazar L, Padoa A, Phillip M. Growth pattern and final height after cessation of gonadotropin-suppressive therapy in girls with central sexual precocity[J]. J Clin Endocrinol Metab, 2007, 92(9): 3483-3489. PMID: 17579199. DOI: 10.1210/jc.2007-0321.
Donbalo?lu Z, Bedel A, ?etiner EB, et al. Effects of the gonadotropin-releasing hormone agonist therapy on growth and body mass index in girls with idiopathic central precocious puberty[J]. Acta Endocrinol (Buchar), 2022, 18(2): 181-186. PMID: 36212259. PMCID: PMC9512371. DOI: 10.4183/aeb.2022.181.
Korkmaz O, Sari G, Mecidov I, et al. The gonadotropin-releasing hormone analogue therapy may not impact final height in precocious puberty of girls with onset of puberty aged 6-8 years[J]. J Clin Med Res, 2019, 11(2): 133-136. PMID: 30701006. PMCID: PMC6340673. DOI: 10.14740/jocmr3710.
Castro C, Espada F, Leite AL, et al. Height benefit of GnRH agonists after age 8 in a Portuguese cohort of central precocious puberty[J]. Clin Endocrinol (Oxf), 2023, 98(5): 670-677. PMID: 36710456. DOI: 10.1111/cen.14884.
Vuralli D, Gonc NE, Ozon ZA, et al. Which parameters predict the beneficial effect of GnRHa treatment on height in girls with central precocious puberty?[J]. Clin Endocrinol (Oxf), 2021, 94(5): 804-810. PMID: 33460480. DOI: 10.1111/cen.14420.
Murato?lu ?ahin N, U?ra? Dikmen A, ?etinkaya S, et al. Subnormal growth velocity and related factors during GnRH analog therapy for idiopathic central precocious puberty[J]. J Clin Res Pediatr Endocrinol, 2018, 10(3): 239-246. PMID: 29687783. PMCID: PMC6083469. DOI: 10.4274/jcrpe.0023.
Kim MS, Koh HJ, Lee GY, et al. Comparing adult height gain and menarcheal age between girls with central precocious puberty treated with gonadotropin-releasing hormone agonist alone and those treated with combined growth hormone therapy[J]. Ann Pediatr Endocrinol Metab, 2019, 24(2): 116-123. PMID: 31261476. PMCID: PMC6603606. DOI: 10.6065/apem.2019.24.2.116.
Fu J, Zhang J, Chen R, et al. Long-term outcomes of treatments for central precocious puberty or early and fast puberty in Chinese girls[J]. J Clin Endocrinol Metab, 2020, 105(3): dgz027. PMID: 31702013. DOI: 10.1210/clinem/dgz027.
