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

Abstract

Background/Aims: Gonadotropin-releasing hormone analogues (GnRHa) represent the gold standard treatment for central precocious puberty (CPP). We aimed to assess the effects of GnRHa treatment on metabolic outcomes, bone status, and polycystic ovary syndrome (PCOS) prevalence in young girls with idiopathic CPP (ICPP). Methods: We enrolled 94 ICPP girls who were at least 2 years after menarche and had already attained adult height at the time of the study: 56 previously treated with depot triptorelin (3.4 ± 0.6 years) and 38 untreated. Auxological parameters, lipid profile, homeostatic model assessment of insulin resistance (HOMA-IR), bone state, and prevalence of PCOS were assessed. Results: The 2 groups were similar for body mass index (BMI) and waist circumference. HOMA-IR, dehydroepi­androsterone sulfate, and Δ4-androstenedione were higher in the treated than in the untreated subjects (p < 0.001). Significant differences were found for amplitude-dependent speed of sound (p < 0.03) and bone transmission time z-scores (p < 0.01). The prevalence of PCOS was higher in the treated than in the untreated subjects (p < 0.04). Conclusion: GnRHa therapy is associated with hyperandrogenism and an increase in insulin resistance and PCOS prevalence, but not with increased BMI or lipid profile alterations. Long-term evaluations at the time of expected peak bone mass achievement are needed to understand the persistent or transient nature of subtle bone abnormalities.

Comparative Efficacy and Safety of Three Current Clinical Treatments for Girls with Central Precocious Puberty: A Network Meta-Analysis

“…First, all research participants of eligible studies were girls diagnosed with CPP. The diagnostic criteria for CPP were as follows: (i) the onset of breast development (Tanner stage B2 or above) before 8 years of chronologic age; (ii) luteinizing hormone (LH) response to GnRH stimulation test (LH peak >5.0 IU/L, LH/follicle-stimulating hormone ratio >0.6); and (iii) no evidence of hypothalamic-pituitary organic lesions observed by magnetic resonance imaging (21,22). Second, eligible studies compared at least two interventions that included GnRHa alone, GnRHa+GH, or a control group.…”

Circulating Endothelial Microparticles Reduce in Concentration Following an Exercise Programme in Women With Polycystic Ovary Syndrome

“…m 2 ) with increased central adiposity (7). The main risk factors for development of PCOS manifest as atypical precocious puberty, premature pubarche, obesity, and metabolic syndromes in childhood (8, 9).…”

A novel heterozygous MKRN3 nonsense mutation in a Chinese girl with idiopathic central precocious puberty

“…However, it is worth mentioning that GnRH analogs treatment has been reported to be associated with a high risk of polycystic ovary syndrome (PCOS). [ 23 ] Our present case was obese accompanied by the IGT, which could also contribute to the development of PCOS. Furthermore, both early puberty and obesity have been documented to be associated with adverse long-term endocrine and metabolic outcomes, including hypertension, type 2 diabetes, stroke, cardiovascular mortality, and cancer.…”