Change in body mass index and insulin resistance after 1-year treatment with gonadotropin-releasing hormone agonists in girls with central precocious puberty

Abstract

PurposeGonadotropin-releasing hormone agonist (GnRHa) is used as a therapeutic agent for central precocious puberty (CPP); however, increased obesity may subsequently occur. This study compared body mass index (BMI) and insulin resistance during the first year of GnRHa treatment for CPP.MethodsPatient group included 83 girls (aged 7.0–8.9 years) with developed breasts and a peak luteinizing hormone level of ≥5 IU/L after GnRH stimulation. Control group included 48 prepubertal girls. BMI and insulin resistance-related indices (homeostasis model assessment of insulin resistance [HOMA-IR] and quantitative insulin sensitivity check index [QUICKI]) were used to compare the groups before treatment, and among the patient group before and after GnRHa treatment.ResultsNo statistical difference in BMI z-score was detected between the 2 groups before treatment. Fasting insulin and HOMA-IR were increased in the patient group; fasting glucose-to-insulin ratio and QUICKI were increased in the control group (all P<0.001). In normal-weight subjects in the patient group, BMI z-score was significantly increased during GnRHa treatment (−0.1±0.7 vs. 0.1±0.8, P<0.001), whereas HOMA-IR and QUICKI exhibited no differences. In overweight subjects in the patient group; BMI z-score and HOMA-IR were not significantly different, whereas QUICKI was significantly decreased during GnRHa treatment (0.35±0.03 vs. 0.33±0.02, P=0.044).ConclusionGirls with CPP exhibited increased insulin resistance compared to the control group. During GnRHa treatment, normal-weight individuals showed increased BMI z-scores without increased insulin resistance; the overweight group demonstrated increased insulin resistance without significantly altered BMI z-scores. Long-term follow-up of BMI and insulin resistance changes in patients with CPP is required.

Longitudinal follow-up to near final height of auxological changes in girls with idiopathic central precocious puberty treated with gonadotropin-releasing hormone analog and grouped by pretreatment body mass index level

“…However, results in reports on the changing patterns of BMISDS during GnRHa treatment after classifying the CPP subjects into BMI-based normal-weight and overweight groups are relatively consistent. As in the present report, most such stratified studies show that the normal-weight group shows increased BMISDS during GnRHa therapy, but, no similar increase in the overweight group [ 12 , 17 , 18 , 24 ]. Then, what is the cause of different BMISDS changes between the 2 groups?…”

The influence of gonadotropin-releasing hormone agonists on anthropometric change in girls with central precocious puberty

“…Similarly, the normal weight group had an incrementally increased WHtR at visits 2 and 3, although the values were not significantly different when we compared visits 1 and 4. Another domestic study has revealed similar tendencies 26) , although the present study involved a longer follow-up after the treatment had been discontinued, which allows us to conclude that abdominal obesity did not develop after termination of the GnRHa treatment.…”

“…Similarly, Yoon et al 27) reported a remarkable increase in zBMI (−0.15±0.72 vs. −0.08±0.66, P <0.05) in the normal weight group after 1 year of GnRHa treatment, although no significant change was observed in the overweight/obese group (1.69±0.51 vs. 1.60±0.48, P >0.05). Furthermore, Park and Kim 26) reported a significant increase in zBMI during the first year of GnRHa treatment (−0.1±0.7 vs. 0.1±0.8, P < 0.001), with no change in the overweight/obese group, although an increase was detected in their insulin resistance index. Nevertheless, it is important to note that the reported correlations between BMI and obesity were limited by the studies' small sample size or an insufficient follow-up period 7 21 25) .…”

“…Nevertheless, it is crucial to understand the effects of GnRHa treatment on obesity among children with CPP, as the prevalence of childhood obesity is gradually increasing and has a problematic relationship with adult obesity and its complications. In Korea, several reports have described BMI changes during GnRHa treatment for girls with CPP, although those studies evaluated relatively small samples and used a limited duration of GnRHa treatment 14 21 23 24 25 26 27) . Therefore, this retrospective study aimed to evaluate the effect of GnRHa treatment on BMI among Korean girls with CPP according to weight status at their diagnosis.…”

Puberte Prekoks ve Pediatri Hemşiresinin Rolü

“…Precocious Puberty (PP), physical and hormonal manifestations of early pubertal development which occurs at an earlier age than the normally accepted limit (3). PP is defined as the development of breast growth (thelarche) in girls before the age of 8, which is the initial limit and the initiation of testis growth before 9 years of age in males (4).…”