Long-term health consequences of central precocious/early puberty (CPP) and treatment with Gn-RH analogue: a short update.
Level 3 - non-randomized controlled study
Systematic review of predominantly observational and cohort studies.
PubMed 38054666 · doi:10.23750/abm.v94i6.15316
What was done
The authors conducted a systematic review searching Medline, PubMed, Google Scholar, and Web of Science for studies published between January 2000 and March 2023. They evaluated the relationship between central precocious/early puberty (CPP) and GnRH analogue (GnRHa) therapy on final adult height, bone mineral density, reproductive function, body mass index, metabolic/cardiovascular abnormalities, cancer risk, and psychological outcomes.
What was found
The abstract reports purely narrative outcomes with no quantitative effect sizes, sample sizes, or confidence intervals: - GnRHa treatment improves final adult height when started before age 6–7 in girls and before age 9 in boys. - Bone mineral density decreases during GnRHa treatment but normalizes post-treatment, with no lasting impact on peak bone mass. - GnRHa treatment does not impair menstrual cycles, whereas untreated CPP increases the risk of premature or early-onset menopause. - PCOS/hyperandrogenemia may be slightly elevated in women with a history of CPP, though overall reproductive function is largely preserved. - Earlier thelarche and menarche may increase susceptibility to breast cancer. - CPP is linked to higher risks of obesity and type 2 diabetes in both sexes, early menarche slightly increases risks of coronary heart disease and ischemic stroke, and early pubertal timing increases risks of depression and anxiety.
Why it matters
This review provides an updated overview of the multi-system consequences of precocious puberty, reassuring clinicians on the long-term safety of GnRHa therapy for bone and reproductive health while highlighting the importance of metabolic and mental health monitoring.
Limits
The abstract provides no quantitative data, effect sizes, search counts, or number of included studies. The underlying literature consists largely of observational cohorts subject to residual confounding, and criteria for study selection and risk-of-bias assessment are not reported.