Bone mineral density and body composition in girls with idiopathic central precocious puberty before and after treatment with a gonadotropin-releasing hormone agonist

Abstract

OBJECTIVES:Idiopathic central precocious puberty and its postponement with a (gonadotropin-releasing hormone) GnRH agonist are complex conditions, the final effects of which on bone mass are difficult to define. We evaluated bone mass, body composition, and bone remodeling in two groups of girls with idiopathic central precocious puberty, namely one group that was assessed at diagnosis and a second group that was assessed three years after GnRH agonist treatment.METHODS:The precocious puberty diagnosis and precocious puberty treatment groups consisted of 12 girls matched for age and weight to corresponding control groups of 12 (CD) and 14 (CT) girls, respectively. Bone mineral density and body composition were assessed by dual X-ray absorptiometry. Lumbar spine bone mineral density was estimated after correction for bone age and the mathematical calculation of volumetric bone mineral density. CONEP: CAAE-0311.0.004.000-06.RESULTS:Lumbar spine bone mineral density was slightly increased in individuals diagnosed with precocious puberty compared with controls; however, after correction for bone age, this tendency disappeared (CD = -0.74±0.9 vs. precocious puberty diagnosis = -1.73±1.2). The bone mineral density values of girls in the precocious puberty treatment group did not differ from those observed in the CT group.CONCLUSION:There is an increase in bone mineral density in girls diagnosed with idiopathic central precocious puberty. Our data indicate that the increase in bone mineral density in girls with idiopathic central precocious puberty is insufficient to compensate for the marked advancement in bone age observed at diagnosis. GnRH agonist treatment seems to have no detrimental effect on bone mineral density.

Body mass index in girls with idiopathic central precocious puberty during and after treatment with GnRH analogues

“…The few reports evaluating body weight status in ICPP patients after GnRHa treatment showed return to pretreatment values [ 27 ] or no differences in BMI when compared to untreated control girls [ 20 , 29 ]. Lazar et al analyzed the evolution of a large cohort of CPP treated patients at the third to fifth decades of life and found that although the BMI was increased at start and during early treatment, it normalized thereafter [ 30 ].…”

“…A few reports have analyzed the influence of GnRHa on body weight according to BMI status at onset of treatment. However, in some of these studies follow-up was limited to a period under treatment or to a short time after withdrawal [ 17 – 19 ], whereas studies with a long-term follow-up did not categorize patients according to pre-treatment BMI status [ 20 , 21 ].…”

Metabolic Outcomes, Bone Health, and Risk of Polycystic Ovary Syndrome in Girls with Idiopathic Central Precocious Puberty Treated with Gonadotropin-Releasing Hormone Analogues

“…Some studies showed BMD values not different between GnRHa-treated and GnRHa-untreated patients [27, 53]. Otherwise, lower BMD and bone strength before and during GnRHa therapy were demonstrated in CPP patients [25, 54, 55], with a completely restored bone mineral content during the first year of therapy [25] or some years after GnRHa withdrawal [10-12].…”

Adolescents with gender dysphoria

“…Indeed, bone mass was not affected when evaluated at final height attainment at age 16-17 years [53][54][55].…”