Long-term effects of GnRH agonist treatment on body mass index in girls with idiopathic central precocious puberty

Abstract

IntroductionStudies evaluating effects of gonadotropin-releasing hormone agonist (GnRHa) on weight and body-mass-index (BMI) in girls with idiopathic central precocious puberty (iCPP) include short-term effects. The aim of this study is to investigate changes in BMI during and 2 years after completion of GnRHa to determine the factors that may impact BMI in girls with iCPP.MethodsMedical files of 138 girls who completed GnRHa were evaluated. All patients had weight and height measurements at the beginning and end of treatment, and 111 patients had anthropometric measurements 2 years after the completion of treatment.ResultsIn the beginning, 82 (59.4%) had normal weight (NW), 42 (30.4%) were overweight (OW), and 14 (10.2%) were obese (OB). Analysis of BMI-standard deviation score (SDS) in the whole group showed an overall increase during GnRHa treatment (0.92 ± 0.74 vs. 1.20 ± 0.51, p < 0.001). Changes in BMI-SDS (ΔBMI-SDS) during GnRHa differed between NW and OW/OB (0.45 ± 0.31 vs. 0.03 ± 0.20, p < 0.001). BMI-SDSs of both groups returned to baseline scores (or initial levels) 2 years after the completion of treatment. Two factors affecting ΔBMI-SDS in multiple linear regression analyses were baseline BMI and Δheight-SDS, both correlated negatively with ΔBMI-SDS.ConclusionsThe present study is one of the studies evaluating BMI change over a long period of time in girls with CPP. Although BMI-SDS increased during GnRHa in NW girls, it was reversible in follow-up after treatment. However, BMI-SDS did not change during and in follow-up in OW/OB girls. Conserving BMI-SDS in OW/OB girls may be related to the fact that weight management programs were recommended for these patients. Dietary recommendations should be provided for children with NW who undergo GnRHa, as is the case for OW patients.

Can Body Mass Index Affect Height Growth at Menarche among Girls Receiving Treatment for Early Puberty? A Retrospective Study in Korean Girls

“…All patients underwent clinical and hormonal assessments every six months until treatment completion. At 3 months of treatment, a GnRH stimulation test was performed to define peak LH levels below 2 IU/L to indicate suppression of the hypothalamic-pituitary-gonadal axis [ 33 ]. The patients visited the hospital within 3 months of menarche.…”

Short-term efficacy of 1-month and 3-month gonadotropin-releasing hormone agonist depots in girls with central precocious puberty

“…There has been controversy about the association between GnRHa treatment and weight gain or obesity [ 24 ]. Several studies have shown increased BMI SDS during GnRHa treatment and decreased BMI SDS after discontinuation of GnRHa [ 25 - 28 ]. In a study with a 1-month GnRHa depot formulation, the proportion of normal weight, overweight, and obese subjects did not differ significantly before and after discontinuation of GnRHa treatment [ 28 ].…”

“…24) Several studies showed increased BMI SDS during GnRHa treatment and decreased BMI SDS after discontinuation of GnRHa. [25][26][27][28] In a study with 1-…”

Effects of High-Glucose and High-Fat Condition on Estrogen Receptor- and Sexual Precocity-Related Genes in GT1-7 Cells

“…The incidence of sexual development disorders in children, especially precocious puberty, has increased significantly in recent years and has become one of the most common pediatric endocrine diseases [9,10], and idiopathic central precocious (idiopathic central precocious puberty, ICPP) is especially important. The direct cause of ICPP is early initiation of the GnRH secretion pulse in the hypothalamus and the increase of the overall level, which activates the pituitary and downstream gonadal organs such as the ovaries and uterus, and makes the HPG axis reach the puberty state prematurely [11,12]. However, the mechanism underlying the abnormal increase in GnRH secretion requires elucidation and is the subject of current research.…”