Adult height after spontaneous pubertal growth or GnRH analog treatment in girls with early puberty: a meta-analysis

Early puberty (EP) has been defined as the onset of puberty in the low-normal range; it may be a cause for concern regarding a possible impairment of adult height (AH). This paper meta-analysed data on AH after spontaneous growth or after gonadotropin-releasing hormone (GnRH) analog treatment in girls with EP. A computerized literature search was conducted from 1980 to June 30, 2016. Only published studies in English were considered. Eight papers were selected (483 cases). In untreated girls (n = 300), predicted adult height (PAH) at start of follow-up (−0.559 SDS (95%CI −1.110 to 0.001); P = 0.050) was close to mid-parental height (MPH) (−0.557 SDS (95%CI −0.736 to −0.419); P < 0.0001) and AH (−0.663 SDS (95%CI −0.803 to −0.524); P < 0.0001). In GnRH analog treated girls (n = 183), PAH before the start of treatment was slightly reduced (−0.939 SDS (95%CI −1.401 to −0.477; P < 0.0001) vs MPH (−0.678 SDS (95%CI −0.942 to −0.414); P < 0.0000), but AH (−0.604 SDS (95%CI −0.877 to −0.338); P < 0.0000) was close to MPH.

Conclusion: Present meta-analysis indicates that girls with EP spontaneously reach their MPH and that GnRH analog treatment does not widely change growth outcome. Differences among the selected studies for definition of EP, inclusion criteria, treatment duration, age at discontinuation of therapy, definition of AH may affect results.