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Independent relationship between body mass index and LH peak value of GnRH stimulation test in ICPP girls: A cross-sectional study

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Summary

The effect of obesity on idiopathic central precocious puberty (ICPP) girls is still under discussion. The relationship between body mass index (BMI) and sexual hormone levels of gonadotropin-releasing hormone (GnRH) stimulation test in ICPP girls is controversial and the underlying mechanism is unclear. This study aims to further explore the independent effect of excess adiposity on peak luteinizing hormone (LH) level of stimulation test in ICPP girls and the role of other related factors. A retrospective cross-sectional study was performed on 618 girls diagnosed as having ICPP, including 355 cases of normal weight, 99 cases of overweight and 164 cases of obese. The results showed that obese group had more progressed Tanner stage and no significant difference (P=0.28) in LH peak was found as basal LH value was used as a covariate. The obese group had higher total testosterone (TT), adrenocorticotrophic hormone (ACTH), 17-α hydroxyprogesterone (17-αOHP) and androstendione (AN), with significantly increased fasting insulin (FIN) and homeostasis model of assessment for insulin resistance index (HOMA-IR). Stratified analysis showed inconsistency of the relationship between BMI-standard deviation score (BMI-SDS) and LH peak in different Tanner stages (P for interaction=0.017). Further smoothing plot showed linear and non-linear relationship between BMI-SDS and LH peak in three Tanner stages. Then linear regression model was used to analyze the relationship between BMI-SDS and LH peak in different Tanner stages, with and without different confounding factors being adjusted. In B2 stage, BMI-SDS was negatively associated with LH peak. In B3 stage, when BMI-SDS <1.5, as BMI-SDS increased, the level of LH peak decreased (model I: β=–1.8, 95% CI=–4.7 to 1.1, P=0.214). When BMI-SDS ≥1.5, BMI-SDS was significantly positively associated with LH peak (model I: β=4.5, 95% CI=1.7 to 7.4, P=0.002). In B4 stage, when BMI-SDS <1.5, BMI-SDS was negatively associated with LH peak (model I: β=–11.6, 95% CI=–22.7 to–0.5, P=0.049). When BMI-SDS ≥1.5, BMI-SDS was positively associated with LH peak (model I: β=–4.2, 95% CI=–3.3 to 11.7, P=0.28). It is concluded that there is an independent correlation between BMI-SDS and LH peak of stimulation test in ICPP girls, their relationships are different in different Tanner stages, and the effect of BMI-SDS can be affected by adrenal androgens, estradiol and glucose metabolism parameters.

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Authors and Affiliations

  1. Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Yue Zhao  (赵 悦), Ling Hou  (侯 凌), Di Zhan  (詹 迪), Cai Zhang  (张 偲) & Xiao-ping Luo  (罗小平)

  2. Department of Pediatrics, Qilu Hospital, Shandong University, Jinan, 250012, China

    Hong-jie Gao  (高洪杰)

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  1. Yue Zhao  (赵 悦)
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  2. Ling Hou  (侯 凌)
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  3. Hong-jie Gao  (高洪杰)
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  4. Di Zhan  (詹 迪)
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  5. Cai Zhang  (张 偲)
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  6. Xiao-ping Luo  (罗小平)
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Correspondence to Xiao-ping Luo  (罗小平).

Additional information

This study was supported by grants from 12th five-year Plan National Key Technology R&D Program (No. 2012BAI09B04) and Program for Changjiang Scholars and Innovative Research Team in University (No. PCSIRT1131).

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Zhao, Y., Hou, L., Gao, Hj. et al. Independent relationship between body mass index and LH peak value of GnRH stimulation test in ICPP girls: A cross-sectional study. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 37, 556–562 (2017). https://doi.org/10.1007/s11596-017-1772-2

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  • DOI: https://doi.org/10.1007/s11596-017-1772-2

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