Abstract
IntroductionThere are several concerns associated with gonadotropin-releasing hormone agonist (GnRHa) treatment for central precocious puberty (CPP), such as obesity and changes in body mass index (BMI). We aimed to investigate whether any anthropometric differences exist and if they persist over time.MethodsWe conducted an observational study of Portuguese children (both sexes) diagnosed with CPP between January 2000 and December 2017, using a digital platform, in order to analyze the influence of GnRHa treatment on BMI-SD score (BMI-SDS).ResultsOf the 241 patients diagnosed with CPP, we assessed 92 patients (8% boys) in this study. At baseline, 39% of the patients were overweight. BMI-SDS increased with treatment for girls but then diminished 1 year after stopping GnRHa therapy (p = 0.018). BMI-SDS variation at the end of treatment was negatively correlated with BMI-SDS at baseline (p < 0.001). Boys grew taller and faster during treatment than did girls (p < 0.001), and therefore, their BMI-SDS trajectory might be different.ConclusionsThis study showed an increase of body weight gain during GnRHa treatment only in girls, which reversed just 1 year after stopping treatment. The overall gain in BMI-SDS with treatment is associated with baseline BMI-SDS.
Highlights
There are several concerns associated with gonadotropin-releasing hormone agonist (GnRHa) treatment for central precocious puberty (CPP), such as obesity and changes in body mass index (BMI)
GnRHa preparations help preserve adult height (AH) and prevent/ameliorate the presumed distress associated with early maturation and menarche in girls [7]
We aimed to evaluate sex-based differences and changes in BMI in a nationally representative group of Portuguese Central precocious puberty (CPP) patients treated with GnRHa and followed up for a year after treatment discontinuation
Summary
There are several concerns associated with gonadotropin-releasing hormone agonist (GnRHa) treatment for central precocious puberty (CPP), such as obesity and changes in body mass index (BMI). Central precocious puberty (CPP) results from the premature activation of the hypothalamic–pituitary–gonadal axis. It mimics physiological pubertal development but occurs at an inappropriate chronological age [1]. It is defined by the onset of pubertal development before the age of 8 and 9 years in girls and boys, respectively [2]. Recognition of CPP facilitates appropriate and prompt intervention such as treatment with gonadotropin-releasing hormone agonists (GnRHas) or surgical intervention in certain cases such as those involving central nervous system tumors [4, 5]. GnRHa preparations help preserve adult height (AH) and prevent/ameliorate the presumed distress associated with early maturation and menarche in girls [7]
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