Impact of gonadotropin-releasing hormone (GnRH) analog therapy on growth and metabolism in girls with central precocious puberty: A narrative review

Abstract

Central precocious puberty (CPP) is a neuroendocrine disorder resulting from premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, leading to accelerated sexual maturation and bone age advancement. A key clinical consequence is impaired growth dynamics, which may result in reduced final height. This narrative review analyzes current evidence on gonadotropin-releasing hormone (GnRH) analogs in CPP, focusing on their effects on growth and metabolic parameters. Treatment suppresses HPG axis activity and slows bone maturation; however, its efficacy depends largely on the patient’s baseline biological advancement rather than chronological age. The impact of therapy on metabolism remains inconclusive. Available data do not demonstrate a consistent, sustained effect on metabolic parameters, and observed changes in body weight and composition are typically transient and influenced by individual factors. GnRH analogs are effective for CPP, particularly in improving growth outcomes. Both growth and metabolic effects are strongly modulated by baseline patient characteristics, underscoring the need for individualized therapy.