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Models for predicting the adult height and age at first menstruation of girls with idiopathic central precocious puberty.

Giabicani E, Lemaire P, Brauner R - PLoS ONE (2015)

Bottom Line: The actual AH was lower than the calculated AH by more than 1 SD (5.6 cm) in 11 girls (8.0%).The similarity of the formulae for both groups suggests that the treatment had no significant effect on the AH.However, the criteria used to select treatment suggest that it prevents the deterioration of AH in cases with rapidly evolving form of CPP.

View Article: PubMed Central - PubMed

Affiliation: Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.

ABSTRACT

Background: It is difficult to determine whether to treat a given girl who has idiopathic central precocious puberty (CPP) with gonadotropin-releasing hormone analog (GnRHa) in terms of adult height (AH). The objective was to provide an easy tool for predicting AH and age at first menstruation at initial evaluation to help guide the decision regarding whether to treat.

Methods: Data analysis using multiple linear regression models was performed in 134 girls with CPP. Among them 78 were given GnRHa because of low predicted AH (n=45), pubertal luteinising hormone (LH)/follicle-stimulating hormone peaks (FSH) ratio (n=50) and/or high plasma estradiol concentration (n=45). 56 girls were followed without treatment.

Results: In the whole population, the actual AH (162.1±5.61 cm) was similar to target height (161.7±4.91 cm) and to AH predicted by the Bayley and Pinneau method (161.9±7.98 cm). Separated models for treated and untreated girls provide very close estimations, leading to a unique formula for both groups. The AH (cm) could be calculated at the initial evaluation: 2.21 (height at initial evaluation, SD) + 2.32 (target height, SD) - 1.83 (LH/FSH peaks ratio) + 159.68. The actual AH was lower than the calculated AH by more than 1 SD (5.6 cm) in 11 girls (8.0%). The time between onset of puberty and first menstruation (in untreated girls) can be estimated with: 10.9 - 0.57 (LH/FSH peaks ratio). The formulae are available at http://www.kamick.org/lemaire/med/girls-cpp15.html.

Conclusions: We established formulae that can be used at an initial evaluation to predict the AH, and the time between onset of puberty and first menstruation after spontaneous puberty. The similarity of the formulae for both groups suggests that the treatment had no significant effect on the AH. However, the criteria used to select treatment suggest that it prevents the deterioration of AH in cases with rapidly evolving form of CPP.

No MeSH data available.


Related in: MedlinePlus

Evolution of consultations and treated girls rates over 26 years in the 134 girls with CPP of the present study.Plain line represents the average of the proportion of treated girls over 7 years (current year, 3 years before and 3 years after).
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pone.0120588.g004: Evolution of consultations and treated girls rates over 26 years in the 134 girls with CPP of the present study.Plain line represents the average of the proportion of treated girls over 7 years (current year, 3 years before and 3 years after).

Mentions: Considering the whole population of CPP, which has been studied for 32 years [15], and the present study, which is limited to those aged over 14 years (26 years), the percentage of the girls with CPP treated with GnRHa varies from year to year, with a clear decreasing trend: this rate of treatment was approximately 70% in the early 1980s and has decreased to approximately 50% in the late 1990s (Fig. 4). The mean AH of the global population and of the treated and untreated groups has not significantly varied over this time. The characteristics at the initial evaluation and the evolution of both the present population and those whose AH we reported in 1994 [2] and in 2002 [14] did not change, including the percentage of those aged less than 6 years. The decrease in the percentage of girls treated is due to our decision to non-stop the secretion of the estradiol. However, this decision has important psychological implications. It is difficult for a girl aged less than 10 years to have pubertal development, mainly menstruations. The criteria of Tanner stage breast development had not been included in the decision to treat, but the inclusion of plasma estradiol concentration in the criteria is associated with significantly greater breast development in the treated group.


Models for predicting the adult height and age at first menstruation of girls with idiopathic central precocious puberty.

Giabicani E, Lemaire P, Brauner R - PLoS ONE (2015)

Evolution of consultations and treated girls rates over 26 years in the 134 girls with CPP of the present study.Plain line represents the average of the proportion of treated girls over 7 years (current year, 3 years before and 3 years after).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383451&req=5

pone.0120588.g004: Evolution of consultations and treated girls rates over 26 years in the 134 girls with CPP of the present study.Plain line represents the average of the proportion of treated girls over 7 years (current year, 3 years before and 3 years after).
Mentions: Considering the whole population of CPP, which has been studied for 32 years [15], and the present study, which is limited to those aged over 14 years (26 years), the percentage of the girls with CPP treated with GnRHa varies from year to year, with a clear decreasing trend: this rate of treatment was approximately 70% in the early 1980s and has decreased to approximately 50% in the late 1990s (Fig. 4). The mean AH of the global population and of the treated and untreated groups has not significantly varied over this time. The characteristics at the initial evaluation and the evolution of both the present population and those whose AH we reported in 1994 [2] and in 2002 [14] did not change, including the percentage of those aged less than 6 years. The decrease in the percentage of girls treated is due to our decision to non-stop the secretion of the estradiol. However, this decision has important psychological implications. It is difficult for a girl aged less than 10 years to have pubertal development, mainly menstruations. The criteria of Tanner stage breast development had not been included in the decision to treat, but the inclusion of plasma estradiol concentration in the criteria is associated with significantly greater breast development in the treated group.

Bottom Line: The actual AH was lower than the calculated AH by more than 1 SD (5.6 cm) in 11 girls (8.0%).The similarity of the formulae for both groups suggests that the treatment had no significant effect on the AH.However, the criteria used to select treatment suggest that it prevents the deterioration of AH in cases with rapidly evolving form of CPP.

View Article: PubMed Central - PubMed

Affiliation: Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.

ABSTRACT

Background: It is difficult to determine whether to treat a given girl who has idiopathic central precocious puberty (CPP) with gonadotropin-releasing hormone analog (GnRHa) in terms of adult height (AH). The objective was to provide an easy tool for predicting AH and age at first menstruation at initial evaluation to help guide the decision regarding whether to treat.

Methods: Data analysis using multiple linear regression models was performed in 134 girls with CPP. Among them 78 were given GnRHa because of low predicted AH (n=45), pubertal luteinising hormone (LH)/follicle-stimulating hormone peaks (FSH) ratio (n=50) and/or high plasma estradiol concentration (n=45). 56 girls were followed without treatment.

Results: In the whole population, the actual AH (162.1±5.61 cm) was similar to target height (161.7±4.91 cm) and to AH predicted by the Bayley and Pinneau method (161.9±7.98 cm). Separated models for treated and untreated girls provide very close estimations, leading to a unique formula for both groups. The AH (cm) could be calculated at the initial evaluation: 2.21 (height at initial evaluation, SD) + 2.32 (target height, SD) - 1.83 (LH/FSH peaks ratio) + 159.68. The actual AH was lower than the calculated AH by more than 1 SD (5.6 cm) in 11 girls (8.0%). The time between onset of puberty and first menstruation (in untreated girls) can be estimated with: 10.9 - 0.57 (LH/FSH peaks ratio). The formulae are available at http://www.kamick.org/lemaire/med/girls-cpp15.html.

Conclusions: We established formulae that can be used at an initial evaluation to predict the AH, and the time between onset of puberty and first menstruation after spontaneous puberty. The similarity of the formulae for both groups suggests that the treatment had no significant effect on the AH. However, the criteria used to select treatment suggest that it prevents the deterioration of AH in cases with rapidly evolving form of CPP.

No MeSH data available.


Related in: MedlinePlus