Monitoring strategy and efficacy of GnRH analogue therapy in girls with central precocious puberty and early puberty.
Journal
Journal of the Formosan Medical Association = Taiwan yi zhi
ISSN
0929-6646
Date Issued
2025-12-20
Author(s)
Liu, Wen-Shin
Tsai, Wei-Yu
Liu, Shih-Yao
Tsai, Meng-Ju Melody
Lin, Han-Yi
Tung, Yi-Ching
Abstract
This study evaluated the effectiveness of gonadotropin-releasing hormone analogue (GnRHa) therapy in girls with central precocious puberty (CPP) and early puberty (EP), aiming to identify a reliable marker for treatment monitoring and assessing long-term outcomes.A retrospective case study between 2001 and 2024, a total of 265 girls with rapidly progressive CPP or EP who received GnRHa therapy were enrolled. A GnRH stimulation test was performed after 12 weeks of therapy. Receiver operating characteristic curves and the Youden index were used to identify an optimal marker and define the cut-off value indicating effective suppression. Among them, 186 reached adult height, and their height outcomes were analyzed to identify predictive factors.After 12 weeks of GnRHa therapy, effective suppression was achieved in 94.3 % of patients. Unstimulated LH was a strong predictor (AUC = 0.85), with a cut-off of <0.4 IU/L (sensitivity, 65.5 %; specificity, 86.7 %). Growth outcomes showed that patients with CPP had better adult height than those with EP (156.5 vs. 153.9 cm, p < 0.001). Positive predictors included second-year growth velocity, predicted adult height at treatment initiation, and bone age standard deviation score, while a unstimulated LH level was negatively associated with final height. Long-term follow-up revealed that 34.9 % of patients had abnormal bone mineral density (31.5 % osteopenia and 3.4 % osteoporosis), although obesity rates were comparable to the general population.This study highlights the importance of early intervention and effective monitoring strategies, with unstimulated LH emerging as a useful marker for treatment efficacy.
Subjects
Bone mineral density
Central precocious puberty
Early puberty
GnRH analogue
GnRH test
Type
journal article