Endocrine Abstracts

JOINT2007

Background: Central precocious puberty (CPP) is the early activation of the hypothalamic-pituitary-gonadal axis, resulting in the onset of puberty in girls before 8 years of age. GnRH analog therapy is commonly used to delay puberty, but it often leads to height suppression and metabolic changes. Growth hormone (GH) supplementation is sometimes added to improve final adult height, but its effect on weight and body mass index (BMI) is not well understood. This study aims to evaluate the impact of GnRH analog therapy vs GnRH analog therapy combined with GH on final height, weight, and BMI in girls with CPP.

Methods: This retrospective cohort study was conducted at Ramallah Governmental Hospital, Palestine, from 2020 to 2023, including 56 girls diagnosed with CPP before the age of 8. The patients were divided into two groups: one group received GnRH analogs only (n = 29), and the other received GnRH analogs with GH therapy (n = 27). They were further categorized into prepubertal (0–8 years), early pubertal (8.1–11 years), and mid-pubertal (11.1–14 years) subgroups. Data on height, weight, BMI, Tanner stage, and hormone levels were collected. Statistical analysis was performed using SPSS version 20, and the independent samples t-test was used for comparison, with statistical significance set at P <0.05.

Results: Both groups experienced significant increases in height after treatment. The mean height in the GnRH analog group increased from 122.31 ± 10.45 cm to 145.84 ± 12.24 cm, while the combination therapy group increased from 111.81 ± 10.37 cm to 136.96 ± 11.67 cm. Weight gain occurred in both groups, but it was more pronounced in the GnRH analog-only group (from 26.12 ± 5.44 kg to 39.36 ± 6.04 kg) compared to the combination therapy group (from 19.84 ± 6.05 kg to 34.94 ± 8.27 kg). Changes in BMI were not significantly different between groups, although the combination therapy group had a lower increase in BMI, particularly in mid-pubertal patients (P =0.024).

Conclusions: Adding GH to GnRH analog therapy improves final height outcomes in girls with CPP without significantly affecting BMI. GH supplementation may also reduce weight gain commonly observed with GnRH analog therapy. These findings emphasize the importance of a personalized approach based on pubertal stage and metabolic risk. Further studies are needed to confirm long-term outcomes and refine treatment strategies.