Predicting the adult height of girls with central precocious puberty.

BACKGROUND: There are no absolute criteria for identifying those girls with idiopathic central precocious puberty (CPP) who will benefit from gonadotropin-releasing hormone analog (GnRHa) treatment. Our objective was to predict at initial evaluation the differences between adult height (AH) and target height (TH) and (for untreated girls) the time between puberty onset and first menstruation. MATERIAL/METHODS: The 122 girls with CPP who reached their AH included 70 who were given GnRHa because their predicted AH was <155 cm (n=24), their luteinising hormone (LH)/follicle-stimulating hormone peaks (FSH) ratio was >0.66 (n=41) and/or their estradiol was >15 pg/ml (n=40). The other 52 were untreated because their predicted AH was >155 cm. Multiple linear regressions were performed on several subsets of variables. RESULTS: Treated: the difference between AH and TH (-0.6±5.4 cm) was predicted by (using SDS) =3.68 (height at initial evaluation - TH) - 1.94 (height at initial evaluation-predicted AH) - 4.23; R2=0.73. Untreated: the difference between AH and TH (1.7±4.3 cm) was predicted by =2.76 (height at initial evaluation - TH) - 3.68 LH/FSH peaks ratio - 3.49; R2=0.77. Time between puberty onset and first menstruation (years) was predicted by =12.2 - 1.06 age CPP - 0.4 (height at initial evaluation - TH); R2=0.75. CONCLUSIONS: A greater difference between height at initial evaluation and TH (SDS) is associated with a greater AH in treated and untreated girls, as are smaller differences between height at initial evaluation and predicted AH in treated and lower LH/FSH peaks ratios in untreated girls.

Idiopathic central precocious puberty in girls: presentation factors.

BACKGROUND: It is sometimes difficult to distinguish between premature thelarche and precocious puberty in girls who develop breasts before the age of 8 years. We evaluated the frequencies of the signs associated with breast development and the factors influencing the presentation of girls with idiopathic central precocious puberty (CPP). METHODS: 353 girls monitored 0.9 +/- 0.7 year after the onset of CPP. RESULTS: The age at CPP was < 3 years in 2%, 3-7 years in 38% and 7-8 years in 60% of cases. Pubic hair was present in 67%, growth rate greater than 2 SDS in 46% and bone age advance greater than 2 years in 33% of cases. Breast development was clinically isolated in 70 (20%) cases. However, only 31 of these (8.8% of the population) had a prepubertal length uterus and gonadotropin responses to gonadotropin releasing hormone and plasma estradiol. The clinical picture of CPP became complete during the year following the initial evaluation.25% of cases were obese. The increase in weight during the previous year (3.7 +/- 1.4 kg) and body mass index were positively correlated with the statural growth and bone age advance (P < 0.0001). There was no relationship between the clinical-biological presentation and the age at puberty, the interval between the onset of puberty and evaluation, or the presence of familial CPP. CONCLUSION: The variation in presentation of girls with CPP does not depend on their age, interval between the onset and evaluation, or familial factors. This suggests that there are degrees of hypothalamic-pituitary-ovarian activation that are not explained by these factors.