Weight Evolution in Girls Treated for Idiopathic Central Precocious Puberty with GnRH Analogues

Abstract

Data concerning the effects of GnRHa on weight gain are scarce. Objective: To assess the variation of the body mass index (BMI) in girls during GnRHa treatment for idiopathic central precocious puberty (CPP). Patients and Methods: Semestral anthropometric data from 176 girls treated with goserelin or leuprorelin were analyzed. Results: BMI z-score increased from 1.5 ± 0.1 SD before treatment (n = 176) to 1.7 ± 0.2 SD after 24 months (n = 61, ρ = 0.008). In girls with normal weight before treatment, this variation was greater (n = 112,0.2 ± 0.1 SD, ρ = 0.01) than in those who were overweight (n = 63, -0.9 ± 0.2 SD, ρ = 0.7). In the goserelin group the weight change adjusted for bone age was greater (n = 28, 0.4 ± 0.1 SD) than in the leuprorelin group (n = 5, 0.04 ± 0.1 SD, ρ = 0.05). Conclusions: A slight increase in BMI was noted, mainly in girls with normal weight before treatment. The influence of different GnRHa on weight must be further investigated.We studied the BMI follow-up of girls treated with GnRHa for CPP. PATIENTS AND METHODSThe aim of this longitudinal retrospective study was to evaluate semestral changes in BMI of 176 Brazilian girls treated with GnRHa for idiopatic central precocious puberty (ICPP), regularly seen at a public health reference center (CEDEBA) in the state of Bahia, Brazil, during a 6-year period (1998)(1999)(2000)(2001)(2002)(2003)(2004).

MANAGEMENT OF ENDOCRINE DISEASE: Long-term outcomes of the treatment of central precocious puberty

“…However, what remains to be clarified is whether it is the high BMI that results in precocious pubertal development or is it the latter that promotes the weight gain (33,35).…”

“…Preliminary studies reported weight gain during treatment with GnRHa in patients with CPP, raising concerns for potential permanent obesity in adulthood (33,35,36). According to two independent studies (33,37) analyzing normal-weight and overweight children separately, BMI-SDS during treatment increased in normalweight children, whereas it remained stable in overweight subjects.…”

“…According to two independent studies (33,37) analyzing normal-weight and overweight children separately, BMI-SDS during treatment increased in normalweight children, whereas it remained stable in overweight subjects. The majority of long-term studies showed an increased prevalence of overweight and obesity in patients with CPP at diagnosis (22,38), but no significant mean or individual BMI-SDS changes were shown at the end of treatment, irrespective of sex, age at puberty onset and at the start and discontinuation of treatment (15,17,22,23,24,25,30,32,39), and type of GnRHa (31).…”

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

“…1 The first-line treatment for CPP consists in long-acting gonadotropin-releasing hormone (GnRH) analogs that act by suppressing puberty during the first three months of treatment in most cases. 2,3 Adverse events are uncommon and include a disproportionate increase in body mass index (BMI) [4][5][6][7][8] at the expense of fat tissue, and the resulting cardiovascular risk. The mechanism by which these patients are prone to overweight or obesity is unknown, and findings from different series have been inconsistent.…”

Evolución del índice de masa corporal en niñas con pubertad precoz en tratamiento

“…1 El tratamiento de primera elección de la PPC es con análogos de acción prolongada de la hormona liberadora de gonadotrofinas (análogo de gonadotropin-releasing hormone; aGnRH, por sus siglas en inglés), con el cual se logra la supresión puberal en los primeros 3 meses de tratamiento en la mayoría de los casos. 2,3 Los efectos adversos son poco frecuentes; entre ellos, se ha reportado el incremento desproporcionado del índice de masa corporal (IMC) [4][5][6][7][8] a expensas del tejido graso, con el consecuente riesgo cardiovascular. El mecanismo por el cual estas pacientes tienen mayor predisposición al sobrepeso u obesidad es incierto y los hallazgos en las diferentes series son inconsistentes.…”