Endocrine Abstracts

JOINT935

Background: Gonadotropin-releasing hormone analogue (GnRHa) being the standard treatment for boys with central precocious puberty (CPP) or early fast puberty (EFP), but a considerable proportion will experience significant growth deceleration. Although combining growth hormone (GH) can counteract it, studies in boys are limited. Stanozolol (ST) offers a promising alternative, yet its efficacy remains understudied. We evaluate the short-term efficacy of GH or ST in CPP or EFP boys experiencing growth deceleration during GnRHa treatment.

Methods: Boys diagnosed with CPP or EFP who experienced excessive decline in growth velocity (GV, < 5 cm/year) after receiving standard GnRHa treatment at the First Affiliated Hospital of Sun Yat-sen University (2000-2024) were included. Eighty-four boys were divided into three groups base on the therapy thereafter: GnRHa monotherapy (Group 1, n = 40), GH combined with GnRHa (Group2, n = 25), and ST combined with GnRHa (Group 3, n = 19). We assessed growth velocity (GV), predicted adult height (PAH), bone age (BA), IGF-1 levels, gonadal axis parameters, and glucose-lipid metabolism at baseline and at the sixth month.

Results: After six months, GV significantly increased in Group 2 [from 3.6 (1.2) to 7.2 (2.9) cm/year] and Group 3 [from 3.6 (1.7) cm/year to 7.1 (2.5) cm/year] compared to the Group 1 [from 4.4 (1.2) cm/year to 4.7 (1.8) cm/year] (P < 0.001 for all comparisons). PAH also significantly increased in Group 2 and 3 compared to the Group 1 (△PAH, Group 1: 1.4 ± 1.9 cm, Group 2: 3.7 ± 2.7 cm, Group 3: 3.3 ± 2.0 cm; P < 0.001 for all comparisons). There was no significant difference in change of GV or PAH between the Group 2 and 3 (P = 0.930 for GV, P = 0.577 for PAH). Changes in GV were not correlated with changes in serum IGF-1 or sex hormone levels. The changes in BA in three groups were all 0.0 (0.3) years (P = 0.895). The Group 2 showed increased fasting insulin (from 9.8 ± 4.2 to 12.8 ± 6.4 uU/mL, P = 0.021) and HOMA-IR (from 2.1 ± 0.9 to 2.8 ± 1.5, P = 0.026), while Group 3 showed decreased HDL-C levels (from 1.4 ± 0.4 to 1.2 ± 0.3 mmol/l, P = 0.042).

Conclusion: Both rhGH and ST effectively reversed growth deceleration and improved PAH without accelerating BA in CPP or EFP boys with excessive growth deceleration during GnRHa treatment, but may differentially impact glucose or lipid metabolism. Further researches are needed to follow up to their adult final height.