Change in body mass index among girls with precocious puberty under treatment

Jn, Zurita Cruz; Díaz, Rodríguez; E, Nishimura Meguro; Má, Villasis Keever; A, De Jesús Rivera Hernández; E, Garrido Magaña

doi:10.5546/aap.2016.eng.143

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…The safety and efficacy of GnRH analogues is well-established [ 36 , 86 ], but the long-term impact on body weight has been the interest of much research. A small number of studies have reported increases [ 88 , 90-93 ] or decreases [ 94 ] in BMI SDS associated with use of GnRHa to treat girls with CPP. However, the majority of studies have shown no significant change [ 95 , 96 ], or transient increases [ 81 , 87 , 97-99 ] during treatment that decrease after termination of therapy.…”

Section: Questions Addressed and Suggestionsmentioning

confidence: 99%

An Approach to the Evaluation and Management of the Obese Child With Early Puberty

Tenedero

Oei

Palmert

2021

Journal of the Endocrine Society

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With the decline in age at onset of puberty and increasing prevalence of childhood obesity, early breast development in young, obese girls has become a more frequent occurrence. Here, we examine available literature to answer a series of questions regarding how obesity impacts the evaluation and management of precocious puberty. We focus on girls as the literature is more robust, but include boys where literature permits.Suggestions include: (1) Age cut-offs for evaluation of precocious puberty should not differ substantially from those used for non-obese children. Obese girls with confirmed thelarche should be evaluated for gonadotropin-dependent, central precocious puberty (CPP) to determine if further investigation or treatment is warranted. (2) Basal luteinizing hormone (LH) levels remain a recommended first-line test. However, if stimulation testing is utilized, there is a theoretical possibility that the lower peak LH responses seen in obesity could lead to a false negative result. (3) Advanced bone age (BA) is common among obese girls even without early puberty; hence its diagnostic utility is limited. (4) Obesity does not eliminate the need for MRI in girls with true CPP. Age and clinical features should determine who warrants neuroimaging. (5) BA can be used to predict adult height in obese girls with CPP to inform counselling around treatment. (6) Use of gonadotropin-releasing hormone analogues (GnRHa) leads to increased adult height in obese girls. (7) Obesity should not limit GnRHa use as these agents do not worsen weight status in obese girls with CPP.

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Section: Questions Addressed and Suggestionsmentioning

confidence: 99%

An Approach to the Evaluation and Management of the Obese Child With Early Puberty

Tenedero

Oei

Palmert

2021

Journal of the Endocrine Society

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The Effect of GnRHa Treatment on Body Mass Index in Central Precocious Puberty: A Systematic Review and Meta-Analysis

Hou,

Ying,

et al. 2024

Horm Res Paediatr

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Background: Recently, numerous studies have addressed the long-term effects of treatment with gonadotropin-releasing hormone analogue (GnRHa) in patients with central precocious puberty (CPP). However, the effects of GnRHa treatment on body mass index (BMI) in patients with CPP remain controversial. Objectives: This systematic review and meta-analysis aimed to evaluate the association between GnRHa treatment and BMI in patients with CPP. Method: A systematic search of databases, PubMed, EMBASE and Web of Science published before August 2021 identified relevant studies. The overall effect analysis was performed using STATA version statistical software 15.0. Results: The study included a total of 28 studies. At the end of GnRHa treatment, the BMI-standard deviation score (BMI-SDS) was greater than baseline BMI-SDS (weighted mean difference (WMD) = 0.14, 95% CI, 0.04-0.23; P = .004), especially in girls with CPP (WMD = 0.15, 95% CI, 0.05-0.25; P = 0.005) and in patients with normal weight (WMD = 0.34, 95% CI, 0.19-0.48, P < 0.001). After reaching adult height, BMI-SDS returned to baseline, suggesting that the effect of GnRHa treatment on BMI would disappear as the child grew (WMD = −0.03, 95% CI, −0.39 to 0.32; P = 0.815). Conclusion: For patients with CPP, while treatment with GnRHa may increase the BMI in the short term after treatment, the BMI is likely to return to normal when the patients reach adult height.

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The effect of GnRH analog treatment on BMI in children treated for precocious puberty: a systematic review and meta-analysis

Zhu,

Qin,

Xue

et al. 2024

Journal of Pediatric Endocrinology and Metabolism

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Introduction The purpose of the present meta-analysis was to systematically evaluate the effect of GnRHa treatment on the BMI of children with precocious puberty after GnRHa treatment as compared to before, and to analyze the effect of GnRHa treatment on the body composition of children with precocious puberty at different BMIs by classifying into normal body mass, overweight, and obese groups according to BMI at the time of initial diagnosis. Content A meta-analysis was performed using Stata 12.0 software by searching PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP database), and Wan fang database for relevant literature on standard deviation score of body mass index (BMI-SDS) after GnRHa treatment as compared to before in children with precocious puberty. Summary A total of eight studies were included with a total sample size of 715 cases, and the results of meta-analysis showed that BMI-SDS increased in children with precocious puberty after GnRHa treatment as compared to before starting [(weighted mean difference (WMD)=0.23, 95 % CI: 0.14–0.33, p=0.000)] and also increased in children with normal body mass [(WMD=0.37, 95 % CI: 0.28–0.46, p=0.000)], and there was no significant change in BMI-SDS in children in the overweight or obese group [(WMD=0.01, 95 % CI: −0.08–0.10, p=0.775)]. Outlook Overall, there was an observed increase in BMI-SDS at the conclusion of GnRHa treatment in children with precocious puberty. Additionally, it was found that the effect of GnRHa treatment on body composition varied among children with different BMI status. Clinicians should emphasize the promotion of a healthy lifestyle and personalized dietary management for children.

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Change in body mass index among girls with precocious puberty under treatment

Cited by 3 publications

References 13 publications

An Approach to the Evaluation and Management of the Obese Child With Early Puberty

An Approach to the Evaluation and Management of the Obese Child With Early Puberty

The Effect of GnRHa Treatment on Body Mass Index in Central Precocious Puberty: A Systematic Review and Meta-Analysis

The effect of GnRH analog treatment on BMI in children treated for precocious puberty: a systematic review and meta-analysis

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