Final height after combined growth hormone and GnRH analogue treatment in adopted girls with early puberty
Article first published online: 2 JAN 2007
Volume 93, Issue 11, pages 1456–1462, November 2004
How to Cite
Tuvemo, T., Jonsson, B., Gustafsson, J., Albertsson-Wikland, K., Aronson, A., Häger, A., Ivarson, S., Kriström, B., Marcus, C., Nilsson, K., Westgren, U., Westphal, O., Aman, J. and Proos, L. (2004), Final height after combined growth hormone and GnRH analogue treatment in adopted girls with early puberty. Acta Paediatrica, 93: 1456–1462. doi: 10.1111/j.1651-2227.2004.tb02629.x
- Issue published online: 2 JAN 2007
- Article first published online: 2 JAN 2007
- Received Apr. 16, 2004; revision received June 28, 2004; accepted June 29, 2004
- GnRH analogue;
- growth hormone;
- controlled clinical trial
Background: Girls adopted from developing countries often have early or precocious puberty, requiring treatment with gonadotrophin-releasing hormone (GnRH) analogues. During such treatment, decreased growth velocity is frequent. Aim: To study whether the addition of growth hormone (GH) to GnRH analogue treatment improves final height in girls with early or precocious puberty. Methods: Forty-six girls with early or precocious puberty (age ± 9.5y) adopted from developing countries were randomized for treatment for 2–4 y with GnRH analogue, or with a combination of GH and GnRH analogue. Results: During treatment, the mean growth velocity in the GH/GnRH analogue group was significantly higher compared to the control group. Combined GH/GnRH analogue treatment resulted in a higher final height: 158.9 cm compared to 155.8 cm in the GnRH analogue-treated group. Three out of 24 girls (13%) in the combined group and nine of the 22 girls (41%) treated with GnRH analogue alone attained a final height below –2 standard deviation scores (SDS).
Conclusion: The difference between the two groups is statistically significant, and possibly of clinical importance. A future challenge is to identify a subgroup with clinically significant advantage of GH addition to GnRH analogue treatment. Being very short on arrival in Sweden and being short and young at start of treatment are possible indicators.