Gonadotropin-Dependent Precocious Puberty: Single-Center Experience From Western India

Area of Science:

• Pediatric Endocrinology
• Reproductive Medicine

Background:

• Gonadotropin-dependent precocious puberty (GDPP) is a condition characterized by early onset of puberty.
• Understanding GDPP characteristics in diverse populations like Indian children is crucial for effective management.

Purpose of the Study:

• To delineate the clinical features of GDPP in Indian children.
• To evaluate the efficacy and safety of long-acting Gonadotropin-Releasing Hormone agonist (GnRHa) therapy.
• To identify diagnostic markers differentiating GDPP from premature thelarche.

Main Methods:

• Retrospective analysis of clinical data from 78 children with GDPP and 12 with premature thelarche in Western India.
• Hormonal assessment including basal and GnRHa-stimulated luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels.
• Evaluation of final attained height compared to predicted adult height in treated girls.

Main Results:

• Earlier pubertal onset observed in boys compared to girls (29 vs 75 months).
• GnRHa stimulation test showed elevated LH levels (≥5 mIU/mL at 60 minutes in most patients).
• A 60-minute stimulated LH/FSH ratio of ≥0.34 effectively differentiated GDPP from premature thelarche; long-acting GnRH agonist therapy improved final height SDS.

Conclusions:

• Long-acting GnRH agonist therapy is safe and effective for Indian children with GDPP.
• The 60-minute stimulated LH/FSH ratio serves as a reliable diagnostic differentiator for GDPP.
• This study provides valuable insights into GDPP management in the Indian subcontinent.