The influence of gonadotropin-releasing hormone agonists on anthropometric change in girls with central precocious puberty

Abstract

PurposeThe potential effect of gonadotropin-releasing hormone agonist (GnRHa) treatment on the weight of girls with central precocious puberty (CPP) remains a controversy. We investigated anthropometric changes during and after GnRHa treatment among girls with CPP.MethodsThis retrospective study evaluated data from 127 girls with CPP who received GnRHa treatment for ≥2 years. Height, weight, and body mass index (BMI) values were compared at the baseline (visit 1), after 1 year of GnRHa treatment (visit 2), the end of GnRHa treatment (visit 3), and 6–12 months after GnRHa discontinuation (visit 4).ResultsThe height z score for chronological age (CA) increased continuously between visit 1 and visit 4. No significant differences were observed in BMI z score for CA between visits 1 and 4. However, an increasing trend in the BMI z score for bone age (BA) was observed between visits 1 and 4. The numbers of participants who were of normal weight, overweight, and obese were 97, 22, and 8, respectively, at visit 1, compared to 100, 16, and 11, respectively, at visit 4 (P=0.48).ConclusionAmong girls with CPP, the overall BMI z score for CA did not change significantly during or after GnRHa treatment discontinuation, regardless of their BMI status at visit 1. However, the BMI z score for BA showed an increasing trend during GnRHa treatment and a decreasing trend after discontinuation. Therefore, long-term follow-up of BMI changes among girls with CPP is required until they attain adult height.

Short-term efficacy of 1-month and 3-month gonadotropin-releasing hormone agonist depots in girls with central precocious puberty

“…In this study, GnRHa treatment significantly increased BMI and BMI SDS in both groups over 1 year of GnRHa treatment, which was in concordance with previous studies. 26,28) However, there was no significant difference in change of BMI SDS regardless of type of GnRHa.…”

“…There has been controversy about the association between GnRHa treatment and weight gain or obesity [ 24 ]. Several studies have shown increased BMI SDS during GnRHa treatment and decreased BMI SDS after discontinuation of GnRHa [ 25 - 28 ]. In a study with a 1-month GnRHa depot formulation, the proportion of normal weight, overweight, and obese subjects did not differ significantly before and after discontinuation of GnRHa treatment [ 28 ].…”

“…Several studies have shown increased BMI SDS during GnRHa treatment and decreased BMI SDS after discontinuation of GnRHa [ 25 - 28 ]. In a study with a 1-month GnRHa depot formulation, the proportion of normal weight, overweight, and obese subjects did not differ significantly before and after discontinuation of GnRHa treatment [ 28 ]. An increase in BMI SDS during GnRHa treatment might reflect relatively more weight gain than height gain because of pubertal suppression by GnRHa.…”

“…24) Several studies showed increased BMI SDS during GnRHa treatment and decreased BMI SDS after discontinuation of GnRHa. [25][26][27][28] In a study with 1-…”

“…month GnRHa depot formulation, the proportion of normal weight, overweight, and obesity was not significantly different in girls with CPP before and after the discontinuation of GnRHa treatment. 28) Increase in BMI SDS during GnRHa treatment might be associated with relatively more gain of weight than height because of pubertal suppression by GnRHa. In this study, GnRHa treatment significantly increased BMI and BMI SDS in both groups over 1 year of GnRHa treatment, which was in concordance with previous studies.…”