Changes in Body Mass Index in Girls with Idiopathic Central Precocious Puberty under Gonadotropin-Releasing Hormone Analogue Therapy: The Spanish Registry

Corripio, Raquel; Soriano‐Guillén, Leandro; Herrero, F. Primo; Cañete, Ramón; Castro-Feijóo, Lidia; Escribano, Aranzazu; Espino, Rafael; Labarta, J I; Argente, Jesús

doi:10.1159/000448552

Cited by 13 publications

(19 citation statements)

References 31 publications

(46 reference statements)

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“…One showed that an increased BMISDS at baseline continuously decreased during and after treatment until final height [ 7 ]. The other, from the Spanish registry, showed continuously increasing trend in BMISDS during and after GnRHa therapy and until final height [ 8 ]. Generally, girls with CPP are reported to have above average BMI before GnRHa treatment [ 9 ], and their early pubertal development is positively associated with obesity [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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

Park

Hwang

Kim

et al. 2018

Ann Pediatr Endocrinol Metab

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Purpose Reported changes in body mass index (BMI) in central precocious puberty (CPP) during and after gonadotropin-releasing hormone analog (GnRHa) treatment are inconsistent. We, therefore, investigated auxological parameters in GnRHa-treated girls with idiopathic CPP (ICPP) until attainment of near final height (NFH). Methods From the medical records of 59 ICPP girls who attained NFH after GnRHa therapy, auxological changes were compared between overweight (BMI≥85th percentile) and normal-weight (BMI<85th percentile) groups. BMIs were changed into standard deviation scores (BMISDSs) for subject chronologic age (BMISDS-CA) and bone age (BMISDS-BA).Results The incidence of overweight including obesity was high at the start of therapy (35.6%). The predicted adult height (PAH) at start of therapy was significantly shorter than the midparental height (MPH), whereas PAH at end of therapy approached MPH, and NFH was greater than MPH. Height velocity (HV) in the overweight group was higher during GnRHa therapy than that in the normal-weight group, but those in the two groups were not different after therapy until NFH. Both BMISDS-CA and BMISDS-BA increased significantly during therapy, but both BMISDSs decreased significantly after therapy until NFH. At NFH, neither BMISDS was different from that at baseline. In the normal-weight group, both BMISDSs increased during therapy and were maintained until NFH. In the overweight group, neither BMISDS changed during therapy, but there was a decrease after therapy until NFH.Conclusions The different patterns of BMISDS change during and after GnRHa therapy until NFH between the 2 groups were related to the different HV during GnRHa therapy.

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Section: Introductionmentioning

confidence: 99%

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

Park

Hwang

Kim

et al. 2018

Ann Pediatr Endocrinol Metab

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“…Therefore, the speculation that HH per se plays a potential role in the physiopathology of obesity is tempting, but there is no evidence to support it. Moreover, the increased percentage of total fat mass reported by some authors reinforces the unfavorable effect of GnRHa on BMI and body composition in patients with idiopathic CPP [26][27][28].…”

Section: Discussionmentioning

confidence: 55%

Long-Term Outcomes of Patients with Central Precocious Puberty due to Hypothalamic Hamartoma after GnRHa Treatment: Anthropometric, Metabolic, and Reproductive Aspects

Ramos¹,

Latrônico²,

Cukier³

et al. 2017

Neuroendocrinology

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Background: Hypothalamic hamartoma (HH) represents the commonest cause of organic central precocious puberty (CPP). Follow-up of these patients in adulthood is scarce. Objective: To describe the anthropometric, metabolic, and reproductive parameters of patients with CPP due to HH before and after treatment with gonadotropin-releasing hormone analog (GnRHa). Methods: We performed a retrospective and cross-sectional study in a single tertiary center including 14 patients (7 females) with CPP due to HH. Results: The mean duration of GnRHa treatment was 7.7 ± 2.4 years in boys and 7.9 ± 2.1 years in girls. GnRHa treatment was interrupted at the mean chronological age (CA) of 12.1 ± 1.1 years in boys and 10.7 ± 0.5 years in girls. At the last visit, the mean CA of the male and female patients was 21.5 ± 3.2 and 24 ± 3.9 years, respectively. Eleven of the 14 patients reached normal final height (FH) (standard deviation score -0.6 ± 0.9 for males and -0.6 ± 0.5 for females), all of them within the target height (TH) range. The remaining 3 patients had predicted height within the TH range. The mean body mass index and the percentage of body fat mass was significantly higher in females, with a higher prevalence of metabolic disorders. All patients presented normal gonadal function in adulthood, and 3 males fathered a child. Conclusion: All patients with CPP due to HH reached normal FH or near-FH. A higher prevalence of overweight/obesity and hypercholesterolemia was observed in the female patients. Finally, no reproductive disorder was identified in both sexes, indicating that HH per se has no deleterious effect on the gonadotropic axis in adulthood.

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“…In the literature, the results of studies evaluating the effects of GnRHa treatment on body weight and BMI are controversial and incompatible with each other. There are studies reporting that GnRHa treatment is linked with body weight, BMI and BMI SDS increases in patients with CPP (4,6,9,10,(25)(26)(27)(28)(29), whereas with other studies, GnRHa treatment is not linked with them (3,5,9,11,12,(30)(31)(32)(33), and even GnRHa treatment decreases BMI (12,13). The reason for the inconsistency between studies is not clear.…”

Section: Discussionmentioning

confidence: 97%

“…Possible causes may include different designs of studies, heterogeneous etiology including idiopathic and organic etiology, different gender and age ranges, different body weights at the beginning of GnRHa treatment, different treatment strategies, and different follow-up intervals. In a recent study conducted in Spain to evaluate BMI SDS of 333 patients with CPP who received GnRHa treatment, a significant increase was determined in BMI SDS during treatment and this increase was reported to continue after the interruption of the GnRHa treatment and reaching adult height (10). Similarly, in the present study, the average BMI SDS of all our patients who received GnRHa treatment increased both in the 1 st and 2 nd years compared to the beginning of treatment and in the 1 st and 2 nd years compared to the 6 th month (Table II).…”

Section: Discussionmentioning

confidence: 99%

“…The results in the studies conducted about the effect of GnRHa treatment on body weight are contradictory. While it is reported in some studies that GnRHa treatment is linked with body fat mass, body weight and body mass index (BMI) increases (4)(5)(6)(7)(8)(9)(10), it is reported not to be linked in other studies (3,5,9,11,12). Even some studies reported that it was associated with a decrease in BMI (12,13).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Gonadotropin-releasing Hormone Analog Treatment on Body Mass Index and Height in Female Patients with Central Precocious Puberty

Buyukınan¹,

Kurku²

2019

jpr

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Gonadotropin-releasing hormone agonists (GnRHa) are widely used in the treatment of central precocious puberty (CPP). There is concern that GnRHa treatment, whose positive effects on the adult height are known, may cause weight gain and body mass index (BMI) increase. The aim of this study was to assess the effect of the GnRHa treatment on BMI and height in female patients with CPP. Materials and Methods: Ninety-two patients diagnosed with idiopathic CPP and 22 patients diagnosed with organic CPP, who received GnRHa treatment were included in the study. Data taken on the treatment start date, 6 th month, 1 st and 2 nd year for height, weight, BMI and bone age were obtained retrospectively from the file records. Results: BMI standard deviation score (SDS) increased during the treatment period in all the patients. In the second year of GnRHa treatment, BMI SDS was higher in the organic CPP, compared to the idiopathic CPP (0.66±0.84 and 1.35±0.72, p=0.007). In both groups, at the beginning of GnRHa treatment, the BMI SDS increase was higher in those patients with normal weight compared to those who were overweight/ obese. In both groups, the prevalence of obesity was higher than the reference population at the beginning of treatment. An increase was determined in the height SDS and predicted adult height in both groups according to bone age. Conclusion: In patients with CPP, the prevalence of obesity was higher in the first application compared to the reference population. In CPP, BMI SDS increased with GnRHa treatment. The weight of the patients at the beginning of the treatment affected the weight and BMI change with GnRHa treatment. Those patients with organic CPP were more prone to weight gain and BMI increase.

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Changes in Body Mass Index in Girls with Idiopathic Central Precocious Puberty under Gonadotropin-Releasing Hormone Analogue Therapy: The Spanish Registry

Cited by 13 publications

References 31 publications

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

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

Long-Term Outcomes of Patients with Central Precocious Puberty due to Hypothalamic Hamartoma after GnRHa Treatment: Anthropometric, Metabolic, and Reproductive Aspects

The Effect of Gonadotropin-releasing Hormone Analog Treatment on Body Mass Index and Height in Female Patients with Central Precocious Puberty

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