Abstract
Objectives1. To determine BMI, obesity/overweight rates, glucose and lipids at baseline, during GnRHa treatment and shortly after therapy discontinuation in female children with CPP and EP. 2. To compare this response to that seen in a similar group of untreated patients.MethodsA retrospective analysis of 71 children with either CPP (n = 37) or EP (n = 34) was undertaken. Forty three were treated with a GnRHa for at least 2 years, while 28 were followed without treatment.ResultsAt the time of diagnosis, a higher BMI (z-score of 1.1 ± 0.8 vs. 0.6 ± 0.7, p = 0.004) and a higher prevalence of obesity/overweight (72.9 vs. 35.3%, p = 0.001) was observed in subjects with CPP when compared to those with EP. Children with EP had higher fasting glucose and total cholesterol than those with CPP. BMI z-score, obesity/overweight rates, fasting glucose and lipids did not change significantly in girls with CPP or EP during 3 yrs of follow up, regardless of treatment. Weight z-scores were higher at 3 years in treated than in untreated girls with CPP (p = 0.02), while it was higher in untreated than in GnRHa-treated patients with EP at baseline, 1, 2 and 3 years (p = 0.007, p = 0.002, p = 0.02 and p = 0.04, respectively) and remained so shortly after stopping therapy (p = 0.03).ConclusionsThere is a high prevalence of obesity/overweight in girls with CPP and EP at diagnosis. However, this risk is greater in CPP than in EP girls. BMI, Obesity/overweight rates, fasting glucose and lipids remained stable in CPP and EP girls regardless of therapy. Weight z-scores were found to be higher in treated CPP girls and in untreated girls with EP.
Highlights
Central precocious puberty (CPP) and early puberty (EP) may be associated with an increased body mass index (BMI), adiposity, and with an increased prevalence of obesity before, during and after discontinuing GnRH analog (GnRHa) treatment when compared with age- and sex-matched reference values of the same population [1,2,3,4]
BMI outcome and the prevalence of obesity in children with CPP or EP treated with a GnRHa [1,2,3,5,6,7,8,9,10,11,12,13,14,15,16,17]
The CPP girls were younger (p =
Summary
Central precocious puberty (CPP) and early puberty (EP) may be associated with an increased body mass index (BMI), adiposity, and with an increased prevalence of obesity before, during and after discontinuing GnRH analog (GnRHa) treatment when compared with age- and sex-matched reference values of the same population [1,2,3,4]. Until 2012, around 20 studies had addressed the BMI outcome and the prevalence of obesity in children with CPP or EP treated with a GnRHa [1,2,3,5,6,7,8,9,10,11,12,13,14,15,16,17]. Obesity in patients with CPP seems to be unrelated to GnRHa administration [1,6] and girls treated in childhood with a GnRHa have been found to have a normal BMI and body composition in early adulthood [17]. One publication documented a reduction of BMI z-score and of the obesity rate in girls with CPP during GnRHa treatment [11]
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