Peer-reviewed article
Long-term clinical outcomes in females with precocious puberty treated with gonadotropin-releasing hormone analogues
Nahla M. Khawaja, Khālid Karakī, Mohammad K. Ruba’I, Yousef Saleh Khader, Arwa Kinani et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study followed up girls who had been treated with GnRH analogue medicines for central precocious puberty, which is unusually early puberty. Of 265 eligible females, 82 (30.9%) took part in a long-term check at an average age of about 17.6 years. On average, their final height was close to the height predicted before treatment, and their bone density was within the expected range. Polycystic ovary syndrome was found in about 1 in 5 participants with data, and about half of the adults tested showed reduced insulin sensitivity. The authors stress that the study had no untreated comparison group and cannot show that the treatment caused these outcomes.
Key points
- 82 of 265 eligible females (30.9%) took part; mean age at final evaluation was 17.61 years and mean treatment duration was 3.14 years.
- Mean final height was 159.85 cm; the difference from baseline predicted adult height was 1.98 cm (95% CI -0.37 to 4.34; P = 0.097).
- The distribution of BMI categories did not change significantly from baseline to final follow-up.
- PCOS was identified in 15 of 67 participants (22.4%), and 14 of 28 adults (50.0%) met each threshold for reduced insulin sensitivity.
- Mean lumbar and femoral BMD Z-scores were -0.25 and -0.55, within age- and sex-referenced ranges.
Limitations
Only 30.9% of eligible patients took part, and there was no untreated comparison group, so the findings describe this cohort and cannot show the effects of GnRHa treatment. Missing values were not imputed, so each outcome covers a different number of participants.
Abstract
Objective To evaluate long-term anthropometric, metabolic, reproductive, and bone mineral density (BMD) outcomes in girls with central precocious puberty (CPP) treated with Gonadotropin-Releasing Hormone analogues (GnRHa). Methods In this retrospective cohort with cross-sectional follow-up assessment, 82 of 265 eligible females (30.9%) with central precocious puberty or central hypothalamic-pituitary-gonadal axis activation who had received GnRHa participated in long-term evaluation. Anthropometric outcomes, insulin sensitivity indices (HOMA-IR and QUICKI), hormonal profile, BMD, and reproductive outcomes including polycystic ovary syndrome (PCOS) were assessed. Analyses used available cases for each outcome; missing values were not imputed. Results The mean age at final evaluation was 17.61 ± 4.3 years, and mean GnRHa treatment duration was 3.14 ± 1.9 years. Mean height at final follow-up was 159.85 ± 6.5 cm; the mean difference from baseline predicted adult height was 1.98 cm (95% CI, -0.37 to 4.34; P = 0.097). The distribution of BMI categories did not change significantly from baseline to final follow-up. Mean HOMA-IR and QUICKI were 3.76 ± 1.82 and 0.319 ± 0.025, respectively; among adults, 14/28 (50.0%) met each prespecified adult-derived threshold for reduced insulin sensitivity. PCOS was identified in 15/67 participants (22.4%). Mean lumbar and femoral BMD Z-scores were -0.25 ± 1.23 and -0.55 ± 1.03, respectively. Conclusions Among participants who completed long-term follow-up, attained height was comparable at the group level with predicted adult and mid-parental height, and mean BMD Z-scores were within age- and sex-referenced ranges. PCOS and PCOS-related features were observed, while insulin sensitivity indices were associated with adiposity. Because only 30.9% of eligible patients participated and there was no untreated comparison group, these findings describe the evaluated cohort and should not be interpreted as causal effects of GnRHa treatment.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Treatment with gonadotropin-releasing hormone analogues (GnRHa)
- Population
- 82 females who had central precocious puberty or central hypothalamic-pituitary-gonadal axis activation and had received GnRHa (mean age 17.61 years at follow-up)
Key finding
Final height of 159.85 cm did not differ significantly from baseline predicted adult height (mean difference 1.98 cm; 95% CI -0.37 to 4.34).
Khawaja et al. · OpenAlex · 5 Oct 2026