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Endocrine

, Volume 54, Issue 2, pp 497–503 | Cite as

Changes in body mass index during gonadotropin-releasing hormone agonist treatment for central precocious puberty and early puberty

  • Hae Sang Lee
  • Jong Seo Yoon
  • Jung Ki Roh
  • Jin Soon HwangEmail author
Original Article

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.

Keywords

Body mass index GnRH agonist Precocious puberty 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    J.C. Carel, J. Leger, Clinical practice. Precocious puberty. N. Engl. J. Med. 358, 2366–2377 (2008)CrossRefPubMedGoogle Scholar
  2. 2.
    J.C. Carel, E.A. Eugster, A. Rogol et al., Consensus statement on the use of gonadotropin-releasing hormone analogs in children. Pediatrics 123, e752–e762 (2009)CrossRefPubMedGoogle Scholar
  3. 3.
    F. Antoniazzi, G. Zamboni, Central precocious puberty: current treatment options. Paediatr. Drugs 6, 211–231 (2004)CrossRefPubMedGoogle Scholar
  4. 4.
    M.L. de Kroon, C.M. Renders, J.P. van Wouwe et al., The Terneuzen Birth Cohort: BMI change between 2 and 6 years is most predictive of adult cardiometabolic risk. PLoS One 5, e13966 (2010)CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    D.J. Barker, C. Osmond, T.J. Forsen et al., Trajectories of growth among children who have coronary events as adults. N. Engl. J. Med. 353, 1802–1809 (2005)CrossRefPubMedGoogle Scholar
  6. 6.
    A.M. Pasquino, I. Pucarelli, F. Accardo et al., Long-term observation of 87 girls with idiopathic central precocious puberty treated with gonadotropin-releasing hormone analogs: impact on adult height, body mass index, bone mineral content, and reproductive function. J. Clin. Endocrinol. Metab. 93, 190–195 (2008)CrossRefPubMedGoogle Scholar
  7. 7.
    S. Heger, C.J. Partsch, W.G. Sippell, Long-term outcome after depot gonadotropin-releasing hormone agonist treatment of central precocious puberty: final height, body proportions, body composition, bone mineral density, and reproductive function. J. Clin. Endocrinol. Metab. 84, 4583–4590 (1999)PubMedGoogle Scholar
  8. 8.
    W. Oostdijk, B. Rikken, S. Schreuder et al., Final height in central precocious puberty after long term treatment with a slow release GnRH agonist. Arch. Dis. Child. 75, 292–297 (1996)CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    W.F. Paterson, E. McNeill, D. Young et al., Auxological outcome and time to menarche following long-acting goserelin therapy in girls with central precocious or early puberty. Clin. Endocrinol. 61, 626–634 (2004)CrossRefGoogle Scholar
  10. 10.
    M.R. Palmert, M.J. Mansfield, W.F. Crowley Jr. et al., Is obesity an outcome of gonadotropin-releasing hormone agonist administration? Analysis of growth and body composition in 110 patients with central precocious puberty. J. Clin. Endocrinol. Metab. 84, 4480–4488 (1999)PubMedGoogle Scholar
  11. 11.
    T. Arrigo, F. De Luca, F. Antoniazzi et al., Reduction of baseline body mass index under gonadotropin-suppressive therapy in girls with idiopathic precocious puberty. Eur. J. Endocrinol. 150, 533–537 (2004)CrossRefPubMedGoogle Scholar
  12. 12.
    B. Wolters, N. Lass, T. Reinehr, Treatment with gonadotropin-releasing hormone analogues: different impact on body weight in normal-weight and overweight children. Horm. Res. Paediatr. 78, 304–311 (2012)CrossRefPubMedGoogle Scholar
  13. 13.
    M.D. Wheeler, Physical changes of puberty. Endocrinol. Metab. Clin. North Am. 20, 1–14 (1991)PubMedGoogle Scholar
  14. 14.
    S. Heger, W.G. Sippell, C.J. Partsch, Gonadotropin-releasing hormone analogue treatment for precocious puberty. Twenty years of experience. Endocr. Dev. 8, 94–125 (2005)PubMedGoogle Scholar
  15. 15.
    S. Bhatia, E.K. Neely, D.M. Wilson, Serum luteinizing hormone rises within minutes after depot leuprolide injection: implications for monitoring therapy. Pediatrics 109, E30 (2002)CrossRefPubMedGoogle Scholar
  16. 16.
    W.W. Greulich, S.I. Pyle. Radiologic Atlas of Skeletal Development of the Hand and Wrist. 2nd edn., Stanford University Press, Standford (1959)Google Scholar
  17. 17.
    J.S. Moon, S.Y. Lee, C.M. Nam et al., 2007 Korean National Growth Charts: review of developmental process and an outlook. Korean J. Pediatr. 51, 1–25 (2008)CrossRefGoogle Scholar
  18. 18.
    N. Bayley, S.R. Pinneau, Tables for predicting adult height from skeletal age: revised for use with the Greulich-Pyle hand standards. J. Pediatr. 40, 423–441 (1952)CrossRefPubMedGoogle Scholar
  19. 19.
    C.B. Ebbeling, D.B. Pawlak, D.S. Ludwig, Childhood obesity: public-health crisis, common sense cure. Lancet 360, 473–482 (2002)CrossRefPubMedGoogle Scholar
  20. 20.
    P.B. Kaplowitz, Link between body fat and the timing of puberty. Pediatrics 121(Suppl 3), S208–S217 (2008)CrossRefPubMedGoogle Scholar
  21. 21.
    C.B. Jasik, R.H. Lustig, Adolescent obesity and puberty: the “perfect storm”. Ann. N Y Acad. Sci. 1135, 265–279 (2008)CrossRefPubMedGoogle Scholar
  22. 22.
    D.B. Dunger, M.L. Ahmed, K.K. Ong, Early and late weight gain and the timing of puberty. Mol. Cell. Endocrinol. 254-255, 140–145 (2006)CrossRefPubMedGoogle Scholar
  23. 23.
    M.A. Magiakou, D. Manousaki, M. Papadaki et al., The efficacy and safety of gonadotropin-releasing hormone analog treatment in childhood and adolescence: a single center, long-term follow-up study. J. Clin. Endocrinol. Metab. 95, 109–117 (2010)CrossRefPubMedGoogle Scholar
  24. 24.
    K.O. Klein, K.M. Barnes, J.V. Jones et al., Increased final height in precocious puberty after long-term treatment with LHRH agonists: the National Institutes of Health experience. J. Clin. Endocrinol. Metab. 86, 4711–4716 (2001)CrossRefPubMedGoogle Scholar
  25. 25.
    A.L. Aguiar, A.C. Couto-Silva, E.J. Vicente et al., Weight evolution in girls treated for idiopathic central precocious puberty with GnRH analogues. J. Pediatr. Endocrinol. Metab. 19, 1327–1334 (2006)CrossRefPubMedGoogle Scholar
  26. 26.
    J.P. Wilding, Neuropeptides and appetite control. Diabet. Med. 19, 619–627 (2002)CrossRefPubMedGoogle Scholar
  27. 27.
    M.R. Palmert, S. Radovick, P.A. Boepple, The impact of reversible gonadal sex steroid suppression on serum leptin concentrations in children with central precocious puberty. J. Clin. Endocrinol. Metab. 83, 1091–1096 (1998)PubMedGoogle Scholar
  28. 28.
    C. Maffeis, R. Franceschi, P. Moghetti et al., Circulating ghrelin levels in girls with central precocious puberty are reduced during treatment with LHRH analog. Eur. J. Endocrinol. 156, 99–103 (2007)CrossRefPubMedGoogle Scholar
  29. 29.
    J.A. De Bond, J.T. Smith, Kisspeptin and energy balance in reproduction. Reproduction 147, R53–63 (2014)CrossRefPubMedGoogle Scholar
  30. 30.
    I.M. van der Sluis, A.M. Boot, E.P. Krenning et al., Longitudinal follow-up of bone density and body composition in children with precocious or early puberty before, during and after cessation of GnRH agonist therapy. J. Clin. Endocrinol. Metab. 87, 506–512 (2002)CrossRefPubMedGoogle Scholar
  31. 31.
    J. Pich, M. Bibiloni Mdel, A. Pons et al., Weight self-regulation process in adolescence: the relationship between control weight attitudes, behaviors, and body weight status. Front. Nutr. 2, 14 (2015)CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    E.M. Forman, M.L. Butryn, A new look at the science of weight control: how acceptance and commitment strategies can address the challenge of self-regulation. Appetite 84, 171–180 (2015)CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Hae Sang Lee
    • 1
  • Jong Seo Yoon
    • 1
  • Jung Ki Roh
    • 1
  • Jin Soon Hwang
    • 1
    Email author
  1. 1.Department of PediatricsAjou University School of Medicine, Ajou University HospitalSuwonKorea

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