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      Relationship between final adult height and birth weight after gonadotropin-releasing hormone agonist treatment in girls with central precocious puberty

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          Abstract

          Purpose

          The clinical significance of birth weight relative to gestational age in girls with central precocious puberty is unclear. This study sought to compare clinical parameters such as final adult height (FAH) and menarche onset after treatment with gonadotropin-releasing hormone agonist (GnRHa) on birth weight in girls with central precocious puberty treated.

          Methods

          This retrospective study reviewed data of 69 girls with precocious puberty who had reached their FAH in a long-term trial of GnRHa treatment between January 2007 and December 2017. The subjects were divided into small for gestational age (SGA) (n=19) and appropriate for gestational age (AGA) (n=50) groups.

          Results

          When starting GnRHa treatment, bone age was 10.9±0.9 and 10.3±0.8 years in the SGA and AGA groups, respectively ( P<0.05). The predicted adult height (PAH) (established according to the Bayley-Pinneau average table) and advanced PAH (established according to the Bayley-Pinneau advanced table) were 151.5±4.8 cm and 155.8±4.9 cm in the SGA group, respectively, and 153.4±5.3 cm and 159.0±6.0 cm in the AGA group. After treatment, no significant difference in bone age was found between the groups. The time to menarche after treatment was 12.5±7.6 and 21.1±12.3 months in the SGA and AGA groups, respectively ( P<0.05). FAH in the SGA and AGA groups was 161.0±4.7 cm and 161.6±5.0 cm, respectively, without a significant difference.

          Conclusions

          SGA girls with precocious puberty have increased bone age and earlier menarche relative to AGA girls. However, no difference in FAH after treatment was found between these groups.

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          Most cited references18

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          Tables for predicting adult height from skeletal age: revised for use with the Greulich-Pyle hand standards.

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            Influence of perinatal factors on the onset of puberty in boys and girls: implications for interpretation of link with risk of long term diseases.

            The authors examined the hypothesis that perinatal factors influence the onset of puberty. Children born as singletons in Uppsala, Sweden, in 1973-1977 were followed for height development before and during their school years (through 16 years of age). In all, 62 children born after preeclampsia, 129 born prematurely, 90 born small for gestational age, 175 born large for gestational age, 49 born short for gestational age, and 38 born tall for gestational age were compared with 688 "normal" children. Differences in age and height at puberty onset and age at menarche were analyzed using the t test and analyses of covariance. For boys, the mean age at puberty onset did not differ between normal boys and those with perinatal factors. Boys born small or short for gestational age were 4 cm shorter than normal boys, and those born large for gestational age were 3 cm taller than normal boys. Among girls, patterns for differences in height were similar. Girls born small for gestational age were 5 months younger than normal girls at the onset of puberty and menarche. Patterns of early childhood growth seemed to explain the relations between these perinatal factors and height and age at puberty. The authors conclude that body size at birth affects stature at puberty; in girls, smallness for gestational age is associated with earlier puberty. Associations between intrauterine exposures and disease risk may be confounded by, or mediated through, effects on adolescence.
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              Early puberty-menarche after precocious pubarche: relation to prenatal growth.

              Girls with precocious pubarche (PP; pubic hair at 0 SD), intermediate birth weight (0 to -2 SD), and lower birth weight (less than -2 SD). At the time of PP diagnosis, age, bone age, and BMI were similar across birth weight subgroups; circulating sex hormone-binding globulin and body height were reduced in PP girls with lower birth weight, and these remained so throughout pubertal development. Onset of puberty occurred earlier in PP girls with lower birth weight; so did menarche. Adult height differed by an average of 6.5 cm (approximately 1 SD) between the upper and lower birth weight subgroups; this difference was essentially achieved before puberty and even before PP. Menarche before age 12.0 years was twofold more prevalent in PP girls than in control subjects. Among PP girls, age at menarche was advanced by 8 to 10 months in lower versus higher birth weight girls. Menarche before age 12.0 years was threefold more prevalent among LBW-PP girls than in control subjects (approximately 75% vs approximately 25%). The link between prenatal growth restraint and early menarche is herewith extended to PP girls. In particular LBW-PP girls may become a target group for interventions directed toward normalization of pubertal onset and progression.
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                Author and article information

                Journal
                Ann Pediatr Endocrinol Metab
                Ann Pediatr Endocrinol Metab
                APEM
                Annals of Pediatric Endocrinology & Metabolism
                Korean Society of Pediatric Endocrinology
                2287-1012
                2287-1292
                March 2020
                31 March 2020
                : 25
                : 1
                : 24-30
                Affiliations
                Department of Pediatrics, Chosun University Hospital, Gwangju, Korea
                Author notes
                Address for correspondence: Eun Young Kim, MD Department of Pediatrics, Chosun University Hostpital, 365 Pilmundaero, Dong-gu, Gwangju 61453, Korea Tel: +82-62-220-3050 Fax: +82-62-227-2904 E-mail: sskey@ 123456chosun.ac.kr
                Author information
                http://orcid.org/0000-0002-3073-5222
                Article
                apem-2020-25-1-24
                10.6065/apem.2020.25.1.24
                7136506
                32252213
                6f8f1a97-9d6a-406b-9312-2df6beda29ed
                © 2020 Annals of Pediatric Endocrinology & Metabolism

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 July 2019
                : 22 August 2019
                : 2 September 2019
                Categories
                Original Article

                precocious puberty,gonadotropin-releasing hormone,birth weight

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