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

Sun-Jin Lee,Sun-Young Kim,Minsun Kim

doi:10.3390/children9010110

Abstract

Gonadotropin-releasing hormone agonist (GnRHa) therapy is used to control puberty progression and it preserves height potential in patients with idiopathic central precocious puberty (ICPP). This study evaluated the correlation between weight and height gain at menarche following GnRHa treatment among girls with ICPP and relatively central early puberty (EP). We investigated height/weight trends and changes in height from diagnosis to menarche in girls with ICPP and EP treated with GnRHa. The mean difference in height (Δheight) from treatment cessation to menarche was 9.79 ± 3.53 cm. Girls were divided into girls with Δheight ≥ 9.79 cm (Group 1) and girls with Δheight < 9.79 cm (Group 2). Although near adult height was significantly higher in Group 1, the mean body mass index (BMI) and weight were significantly lower at diagnosis, treatment discontinuation, and menarche. The BMI and weight at the three time points were negatively correlated with height. Girls with higher BMI at all three time points had slower growth rates during the study period. Considering that BMI and body weight were closely related to Δheight, proper management of BMI and body weight of girls receiving early puberty treatment might contribute to growth during and after GnRHa treatment.

Highlights

With time, the annual incidence of central precocious puberty (CPP) has increased, and the age of onset of puberty has lowered worldwide [1]
To gain a better understanding of the effects of gonadotropin-releasing hormone (GnRH) agonist (GnRHa) treatment on body mass index (BMI), we focused on the relationship between the discontinuation of GnRHa treatment and menarche and investigated the BMI from diagnosis to menarche and the height difference from the discontinuation of GnRHa treatment to menarche in girls with idiopathic central precocious puberty (ICPP) and early puberty (EP) who received GnRHa therapy
12 girls who received combination therapy consisting of a growth hormone (GH) and GnRHa, 4 who did not have any record of bone age (BA) at menarche, 15 who were not followed up after menarche, and 24 who were lost to follow-up during treatment were excluded

Summary

Introduction

The annual incidence of central precocious puberty (CPP) has increased, and the age of onset of puberty has lowered worldwide [1]. Precocious puberty is defined as the development of secondary sexual characteristics before the age of eight years in girls and nine years in boys. CPP is caused by a hypothalamic gonadotropin-releasing hormone (GnRH) pulse generator with subsequent pulsatile gonadotropin secretion [2]. This condition limits the final adult height owing to rapid growth velocity and early epiphyseal closure [3]. CPP treatment aims to delay the early progression of puberty, inhibit epiphyseal growth to prevent shorter adult height, and to allow normal sexual maturation to reduce psychosocial problems [4,5]

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