PMID- 36531464 OWN - NLM STAT- MEDLINE DCOM- 20221220 LR - 20230126 IS - 1664-2392 (Print) IS - 1664-2392 (Electronic) IS - 1664-2392 (Linking) VI - 13 DP - 2022 TI - Final adult height in children with central precocious puberty - a retrospective study. PG - 1008474 LID - 10.3389/fendo.2022.1008474 [doi] LID - 1008474 AB - BACKGROUND/AIMS: Central precocious puberty (CPP) is due to premature activation of the hypothalamic-pituitary-gonadal axis. It predominantly affects girls. CPP leads to lower final height (FH), yet the treatment benefit in girls between 6 and 8 years is equivocal. Our main goal was to evaluate the effects of gonadotropin-releasing hormone analog (GnRHa) on FH and identify factors that predict FH. METHODS: In a retrospective study, children with CPP (12 boys, 81 girls) that reached FH were included. Their clinical data at diagnosis and up to their final height was compared by descriptive statistics among idiopathic (iCPP) (n=68) and non-idiopathic CPP (nCPP) and between GnRHa treated (n=48) and untreated (n=15) girls with iCPP. The treatment effect of body weight (BW) adjusted GnRHa dosing was evaluated. Univariate linear regression and step-wise multivariable regression including 48 girls with iCPP treated with GnRHa were performed to identify predicting factors for FH. RESULTS: Children with idiopathic CPP (iCPP) reached higher FH (p=0.002) than children with non-idiopathic CPP. After the diagnosis, the treated group gained 7.0 cm more than the untreated group. Yet, attributable to individualized decision-making, the FH in both groups was comparable (161.5 cm in treated, 161.0 cm in untreated girls with iCPP), although the onset of menarche was 2.5 years earlier among untreated girls. BW-adjusted dosing suppressed peak luteinizing hormone (LH) below 4.5 IU/L in 95% of children; however, bone age further advanced during therapy in 38% of patients. Predicting factors revealed by multivariable regression were bone age at diagnosis, BMI SDS at diagnosis, LH basal, age at start and cessation of treatment, predicted adult height and target height. (R2 = 0.72). CONCLUSION: Children with nCPP had worse FH outcome compared to iCPP despite similar CPP onset and therapeutic characteristics. Treatment by GnRHa using BW-adjusted dosing was effective in delaying menarche onset and reaching target height in girls with iCPP. Multiple factors affecting FH outcome indicated individualized decision-making regarding therapeutic intervention remains challenging. In the treated patients, among the factors that can be influenced, height at treatment cessation most significantly influenced the outcome. CI - Copyright (c) 2022 Knific, Lazarevic, Zibert, Obolnar, Aleksovska, Suput Omladic, Battelino and Avbelj Stefanija. FAU - Knific, Taja AU - Knific T AD - Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. FAU - Lazarevic, Melisa AU - Lazarevic M AD - Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. FAU - Zibert, Janez AU - Zibert J AD - Centre for Health Informatics and Statistics, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia. FAU - Obolnar, Nika AU - Obolnar N AD - Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia. FAU - Aleksovska, Natasa AU - Aleksovska N AD - Department of Vascular Surgery, Izola General Hospital, Izola, Slovenia. FAU - Suput Omladic, Jasna AU - Suput Omladic J AD - Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia. FAU - Battelino, Tadej AU - Battelino T AD - Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. AD - Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia. FAU - Avbelj Stefanija, Magdalena AU - Avbelj Stefanija M AD - Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. AD - Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20221202 PL - Switzerland TA - Front Endocrinol (Lausanne) JT - Frontiers in endocrinology JID - 101555782 RN - 33515-09-2 (Gonadotropin-Releasing Hormone) RN - 9002-67-9 (Luteinizing Hormone) SB - IM MH - Female MH - Male MH - Child MH - Humans MH - Adult MH - *Puberty, Precocious/drug therapy MH - Retrospective Studies MH - Gonadotropin-Releasing Hormone MH - Body Height MH - Body Weight MH - Luteinizing Hormone PMC - PMC9757689 OTO - NOTNLM OT - central precocious puberty OT - final adult height OT - gonadotropin-releasing hormone analog OT - growth OT - height prediction OT - triptorelin COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/12/20 06:00 MHDA- 2022/12/21 06:00 PMCR- 2022/01/01 CRDT- 2022/12/19 03:53 PHST- 2022/07/31 00:00 [received] PHST- 2022/11/14 00:00 [accepted] PHST- 2022/12/19 03:53 [entrez] PHST- 2022/12/20 06:00 [pubmed] PHST- 2022/12/21 06:00 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fendo.2022.1008474 [doi] PST - epublish SO - Front Endocrinol (Lausanne). 2022 Dec 2;13:1008474. doi: 10.3389/fendo.2022.1008474. eCollection 2022.