Long-term outcome after deport gonadotropin-releasing hormone agonist treatment of central precocious puberty: Final height, body proportions, body composition, bone mineral density, and reproductive function

A considerable number of patients with central precocious puberty (CPP) tre ated with depot GnRH agonists have reached final height (FH). The aim of th is prospective, multicentric study was the evaluation of the benefits, side -effects, and long term outcome of depot GnRH agonist therapy. We investiga ted 50 young women (mean +/- SD age, 16.7 +/- 2.6 yr; range, 12.9-23.4 yr) at FH. They received depot triptorelin over a period of 4.4 +/- 2.1 yr (ran ge, 1.0-9.7 yr). Target height (TH) and predicted adult height (PAH) at the start of treatment were 163.6 +/- 6.2 and 154.9 +/- 9.6 cm, respectively ( P < 0.05). FH was 160.6 +/- 8.0 cm (FH vs. TH, P = NS; FH vs. PAH, P < 0.05 ). Young patients showed the highest height gain (FH minus initial PAH). Se venty-eight percent of all patients reached a FH within their TH range. Eve n in young patients and those with an unfavorable initial PAH below the TH range, 60% reached a FH within their individual TH range. Standardized bone mineral density and standardized bone mineral density SD score investigate d by dual energy x-ray absorptiometry of the lumbar spine (L1-L4) were 1040 .9 +/- 124.2 mg/cm(2) and 0.0 +/- 1.0; those of the femoral neck were 902.2 +/- 115.4 mg/cm(2) and 0.2 +/- 1.0, respectively. The so score of the rati o of sitting height over lower leg length was normal (0.3 +/- 1.2). Body ma ss index sn scores at pretreatment, at the end of treatment, and at FH were not significantly different (2.0 +/- 2.0, 2.0 +/- 2.0, and 1.7 +/- 2.2, re spectively). Menarche or remenarche started at age 12.3 +/- 1.4 yr (range, 9.3-15.8 yr) in all patients. In conclusion, long term depot GnRH agonist treatment of CPP girls preserve d genetic height potential and improved FH significantly combined with norm al body proportions. No negative effect on bone mineral density and reprodu ctive function was seen. Treatment neither caused nor aggravated obesity.