The effect of GnRHa combined with rhGH treatment on adult height in girls with idiopathic central precocious puberty
Objective To evaluate the effect and influencing factors of gonadotropin-releasing hormone analog(GnRHa)combined with recombinant human growth hormone(rhGH)on the improvement of adult height in girls with idiopathic central precocious puberty(ICPP).Methods A retrospective analysis was conducted on 60 girls with ICPP who were diagnosed with idiopathic central precocious puberty and received drug treatment at the Children's Healthcare Institution of Hunan Children's Hospital from January 2015 to December 2019.They were divided into GnRHa group and GnRHa+rhGH group based on the presence or absence of combined rhGH.Changes in bone age(BA)/age(CA),sex hormones,growth rate(GV),predicted adult height(PAH),year-end height(FAH),height benefit(FAH-PAH),and bone age assessment height standard deviation score(HtSDSBA)were analyzed.Multiple linear regression analysis was conducted on the influencing factors of height benefits in children with ICPP.Results After drug treatment,the peak value,ratio,and BA/CA ratio of sex hormones in 60 ICCP girls all decreased,and the differences were statistically significant(all P＜0.05).The second year growth rate(GV2)of the two groups of patients decreased compared to the first year growth rate(GV1),and the difference was statistically significant(all P＜0.05).There was a statistically significant difference in FAH-PAH and △ HtSDSBA between the two groups(t=4.056,P＜0.001,t=-6.238,P＜0.001).Pearson correlation analysis results showed that the indicators related to FAH-PAH included CA(r=-0.477,P＜0.01),total treatment period(r=0.441,P＜0.01),pre-treatment PAH(r=-0.533,P＜0.01),and post-treatment HtSDSBA(r=0.271,P＜0.05).Linear regression analysis with height benefit as the dependent variable showed that pre-treatment PAH(β=-0.674,t=-8.713,P＜0.001)and post-treatment HtSDSBA levels(β=4.362,t=6.223,P＜0.001)were independent influencing factors of height benefit in girls with ICPP.The lower the pre-treatment PAH level and the higher the post-treatment HtSDSBA,the greater the height benefit.Conclusions GnRHa combined with rhGH treatment or GnRHa treatment can improve adult height in ICCP girls,but the combination therapy has better height benefits.For girls with severe PAH damage,GnRHa combined with rhGH treatment should be prioritized.
Recombinant human growth hormoneGonadotropin releasing hormone analogsIdiopathic central precocious pubertyPredicted adult heightFinal adult height
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