Treatment outcomes of gonadotropin-releasing hormone agonist in obese girls with central precocious puberty

Abstract

Purpose This study investigated the influence of obesity on the clinical course and effect of gonadotropin-releasing hormone analog (GnRHa) treatment in girls with central precocious puberty (CPP).Methods Medical records of 182 girls with CPP treated with GnRHa were reviewed. They were divided into 2 groups: normal weight (n=108) and overweight/obesity (n=74). Chronological age (CA), bone age (BA), difference between BA and CA (BA–CA), standard deviation score (SDS) of height, body mass index (BMI), predicted adult height (PAH), and laboratory findings were compared at baseline, after 1 year, and at the end of GnRHa treatment in both groups.Results Mean BMI SDS at baseline was 0.08±0.60 in the normal weight group and 1.55±0.36 in the overweight/obesity group. Initial CA, BA, midparental height, and PAH were similar between the 2 groups. BA–CA after treatment was significantly decreased compared to baseline in both groups (P<0.001). Between the 2 groups, a decrease in BA–CA during treatment showed no significant difference. PAH at the end of treatment was significantly increased compared to baseline in both groups (P<0.001). PAH at the end of treatment in the overweight/obesity group (159.88±3.41 cm) was similar to that of the normal weight group (159.19±3.25 cm). Comparing the 2 groups according to change in BMI after treatment, there were no differences in ΔPAH, ΔBA–CA, and Δheight SDS for BA.Conclusions GnRHa treatment in obese girls with CPP improved the height outcome and had similar results in normal weight CPP girls. Obesity might not affect the efficacy of GnRHa in girls with CPP.

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

“…Thus, even if GnRHa use is not associated with increases in BMI SDS, there is a need for counseling and intervention regarding healthy diet and lifestyle for many children with CPP and their families. Given data indicating that some nonobese girls may also experience a transient increase in BMI SDS with initiation of GnRHa therapy, the need for lifestyle counseling may also be relevant to nonobese children with CPP to help ensure any increases do not persist posttreatment [ 81 , 84 , 89 , 95 , 101-104 ]. Long-term studies of treated girls with CPP provide reassurance that treatment is not associated with increased risk of obesity or poor metabolic outcomes [ 95 , 104 ].…”

Do GnRH Agonists Really Increase Body Weight Gain? Evaluation of a Multicentric Portuguese Cohort of Patients With Central Precocious Puberty

“…Some studies have reported an association between GnRHa treatment and body mass index (BMI) increase (9,(11)(12)(13), in previously normal-weight girls (14,15) as well as in those with obesity (16). Other studies have found no influence of GnRHa treatment on weight status (8,17,18), and recently, it has been proposed that the increase of BMI occurs during treatment but reverts to baseline after GnRHa is discontinued (19,20).…”

Dậy thì sớm trung ương ở trẻ thừa cân/béo phì

“…Về hiệu quả của GnRH trên chiều cao, hầu hết các nghiên cứu đều kết luận rằng mặc dù nhóm trẻ béo phì có tuổi xương tiến triển hơn nhưng việc sử dụng GnRHa vẫn giúp làm chậm tiến triển tuổi xương, cho phép đạt được chiều cao cuối cùng phù hợp với chiều cao trung bình theo bố mẹ (MPH) [25][26][27][28][29].…”