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Peer-reviewedCC BYFrontiers in endocrinology

Long-term clinical outcomes in females with precocious puberty treated with gonadotropin-releasing hormone analogues.

  1. 1Department of Endocrinology, The National Center (Institute) for Diabetes, Endocrinology, and Genetics, The University of Jordan, Amman, Jordan.
  2. 2Department of Public Health, Jordan University of Science and Technology (JUST), Irbid, Jordan.
  3. 3Faculty of Medicine, The University of Jordan, Amman, Jordan.

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.

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BibTeX
@article{khawaja2026longterm,
  title = {{Long-term clinical outcomes in females with precocious puberty treated with gonadotropin-releasing hormone analogues.}},
  author = {Nahla Khawaja and Khalid Karaki and Mohammad K Ruba'i and Yousef Khader and Arwa Kinani and Oraib Farahid and Mohammed El-Khateeb and Omar Ali and Abdulrahman Abujbara and Laith Hyasat and Kamel Ajlouni},
  journal = {Frontiers in endocrinology},
  year = {2026},
  month = oct,
  doi = {10.3389/fendo.2026.1911743},
  url = {https://europepmc.org/article/MED/42898185},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Long-term clinical outcomes in females with precocious puberty treated with gonadotropin-releasing hormone analogues.
AU  - Nahla Khawaja
AU  - Khalid Karaki
AU  - Mohammad K Ruba'i
AU  - Yousef Khader
AU  - Arwa Kinani
AU  - Oraib Farahid
AU  - Mohammed El-Khateeb
AU  - Omar Ali
AU  - Abdulrahman Abujbara
AU  - Laith Hyasat
AU  - Kamel Ajlouni
PY  - 2026
DA  - 2026/10/05
JO  - Frontiers in endocrinology
DO  - 10.3389/fendo.2026.1911743
UR  - https://europepmc.org/article/MED/42898185
AB  - 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.
SN  - 1664-2392
ER  -