Development of a parsimonious predictive model for height gain outcome in children with central precocious puberty following gonadotropin-releasing hormone agonist therapy.
Bone age advancement strongly predicts poor height gain on GnRH agonist therapy
Development of a parsimonious predictive model for height gain outcome in children with central precocious puberty following gonadotropin-releasing hormone agonist therapy.
Central precocious puberty (central precocious puberty) is associated with compromised adult height if untreated, and gonadotropin-releasing hormone agonist (GnRHa) therapy remains the standard treatment.
This study aimed to identify prognostic determinants of suboptimal height gain during GnRHa therapy and to develop a parsimonious predictive model to facilitate evidence-based clinical decision-making and optimal intervention timing.
Were stratified into favorable and unfavorable outcome cohorts based on height gain during treatment.
greater bone age advancement over chronological age strongly predicts poor height gain
The area under the curve (AUC) was 0.838 (95% CI: 0.774-0.903) for M0, 0.664 (95% CI: 0.573-0.754) for M1, and 0.815 (95% CI: 0.748-0.883) for M2.
DeLong test revealed no significant difference between M2 and M0 (ΔAUC =-0.023, P=0.24).
M2 exhibited optimal calibration slope (0.957, 95% CI: 0.642-1.389) closest to unity.
DCA demonstrated comparable clinical net benefit for M0 and M2 across 1-50% risk thresholds.
The parsimonious model (M2) incorporating IGF-1 standard deviation score and bone age advancement demonstrates robust predictive capability for height gain outcome in children with central precocious puberty receiving GnRHa therapy, comparable to the comprehensive model.
This model may support early risk stratification and closer growth monitoring in selected patients; however, external validation and confirmation against final adult height outcomes are required before it can inform decisions about adjunctive interventions.