Changes in body mass index during gonadotropin-releasing hormone agonist treatment for central precocious puberty and
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ORIGINAL ARTICLE
Changes in body mass index during gonadotropin-releasing hormone agonist treatment for central precocious puberty and early puberty Hae Sang Lee1 Jong Seo Yoon1 Jung Ki Roh1 Jin Soon Hwang1 ●
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Received: 28 February 2016 / Accepted: 13 June 2016 © Springer Science+Business Media New York 2016
Abstract Gonadotropin-releasing hormone agonists (GnRHa) have been widely used for decades to treat patients with central precocious puberty (CPP). Several studies have investigated changes in body composition in patients with CPP following GnRHa treatment, but the results are inconsistent. The aim of this study was to investigate changes in body mass index (BMI) in children treated with GnRHa for 2 years. We also assessed whether BMI affects treatment outcomes. This study included 383 girls (214 girls with central precocious puberty and 169 girls who underwent early puberty) treated with depot leuprolide acetate monthly for at least 2 years. We analyzed changes in BMI standard deviation score (SDS). Furthermore, blood luteinizing hormone (LH) levels were determined 30 min after depot leuprolide acetate administration every 6 months to evaluate adequate suppression of the hypothalamic-pituitary-gonadal axis. Pretreatment mean BMI SDS values were 0.07 ± 0.69, 1.29 ± 0.16, and 1.95 ± 0.32 in the normal weight, overweight, and obese subjects, respectively. Mean BMI SDS values after 2 years of treatment increased significantly only in normal weight children (0.07 ± 0.69 vs. 0.25 ± 0.73, P < 0.001). LH levels 30 min after leuprolide injection after 2 years of treatment were not different among normal weight, overweight, and obese subjects. Although the difference in BMI SDS was relatively small, it standard deviation score increased significantly after 2 years of treatment in normal weight girls with early pubertal development.
* Jin Soon Hwang [email protected] 1
Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, San 5, Wonchondong, Yeongtong-gu, Suwon, Korea
Keywords Body mass index GnRH agonist Precocious puberty ●
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Introduction Central precocious puberty (CPP) is defined as activation of the hypothalamic-pituitary-gonadal axis before the age of 8 years in girls and 9 years in boys [1]. Gonadotropinreleasing hormone agonists (GnRHa) are the treatment of choice for CPP and have been widely used for decades [2]. The primary aim of GnRHa treatment for patients with CPP is the effective and selective suppression of gonadal sex steroid secretion to stop premature sexual maturation by desensitizing gonadotropin receptors. In addition, treatment should allow attainment of acceptable adult height, consistent with each individual’s genetic determinants, by suppressing accelerated skeletal maturation [3]. Despite the safety and proven benefit of GnRHa, concerns have been raised about the development of adiposity before and after GnRHa treatment in children with CPP. The increase of body mass index (BMI) as well as BMI itself in childhood and adolescence is positively correla
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