Skip to main content
Top
Published in: International Journal of Pediatric Endocrinology 1/2014

Open Access 01-12-2014 | Research

Higher prevalence of obesity and overweight without an adverse metabolic profile in girls with central precocious puberty compared to girls with early puberty, regardless of GnRH analogue treatment

Authors: Ana Colmenares, Peter Gunczler, Roberto Lanes

Published in: International Journal of Pediatric Endocrinology | Issue 1/2014

Login to get access

Abstract

Objectives

1. 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.

Methods

A 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.

Results

At 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).

Conclusions

There 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.
Literature
1.
go back to reference Palmert MR, Mansfield MJ, Crowley WF, Crigler JF, Crawford JD, Boepple PA: 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. 1999, 84 (12): 4480-4488.PubMed Palmert MR, Mansfield MJ, Crowley WF, Crigler JF, Crawford JD, Boepple PA: 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. 1999, 84 (12): 4480-4488.PubMed
2.
go back to reference Paterson WF, McNeill E, Young D, Donaldson MD: Auxological outcome and time to menarche following long-acting goserelin therapy in girls with central precocious or early puberty. Clin Endocrinol (Oxf). 2004, 61 (5): 626-634. 10.1111/j.1365-2265.2004.02146.x.CrossRef Paterson WF, McNeill E, Young D, Donaldson MD: Auxological outcome and time to menarche following long-acting goserelin therapy in girls with central precocious or early puberty. Clin Endocrinol (Oxf). 2004, 61 (5): 626-634. 10.1111/j.1365-2265.2004.02146.x.CrossRef
3.
go back to reference Traggiai C, Perucchin PP, Zerbini K, Gastaldi R, De Biasio P, Lorini R: Outcome after depot gonadotrophin-releasing hormone agonist treatment for central precocious puberty: effects on body mass index and final height. Eur J Endocrinol. 2005, 153 (3): 463-464. 10.1530/eje.1.01975.CrossRefPubMed Traggiai C, Perucchin PP, Zerbini K, Gastaldi R, De Biasio P, Lorini R: Outcome after depot gonadotrophin-releasing hormone agonist treatment for central precocious puberty: effects on body mass index and final height. Eur J Endocrinol. 2005, 153 (3): 463-464. 10.1530/eje.1.01975.CrossRefPubMed
4.
go back to reference Tascilar ME, Bilir P, Akinci A, Kose K, Akcora D, Inceoglu D, Fitöz SO: The effect of gonadotropin-releasing hormone analog treatment (leuprolide) on body fat distribution in idiopathic central precocious puberty. Turk J Pediatr. 2011, 53 (1): 27-33.PubMed Tascilar ME, Bilir P, Akinci A, Kose K, Akcora D, Inceoglu D, Fitöz SO: The effect of gonadotropin-releasing hormone analog treatment (leuprolide) on body fat distribution in idiopathic central precocious puberty. Turk J Pediatr. 2011, 53 (1): 27-33.PubMed
5.
go back to reference Lazar L, Padoa A, Phillip M: Growth pattern and final height after cessation of gonadotropin-suppressive therapy in girls with central sexual precocity. J Clin Endocrinol Metab. 2007, 92 (9): 3483-3489. 10.1210/jc.2007-0321.CrossRefPubMed Lazar L, Padoa A, Phillip M: Growth pattern and final height after cessation of gonadotropin-suppressive therapy in girls with central sexual precocity. J Clin Endocrinol Metab. 2007, 92 (9): 3483-3489. 10.1210/jc.2007-0321.CrossRefPubMed
6.
go back to reference Heger S, Partsch CJ, Sippell WG: 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. 1999, 84 (12): 4583-4590.PubMed Heger S, Partsch CJ, Sippell WG: 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. 1999, 84 (12): 4583-4590.PubMed
7.
go back to reference Pasquino AM, Pucarelli I, Accardo F, Demiraj V, Segni M, Di Nardo R: 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. 2008, 93 (1): 190-195. 10.1210/jc.2007-1216.CrossRefPubMed Pasquino AM, Pucarelli I, Accardo F, Demiraj V, Segni M, Di Nardo R: 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. 2008, 93 (1): 190-195. 10.1210/jc.2007-1216.CrossRefPubMed
8.
go back to reference Feuillan PP, Jones JV, Barnes K, Oerter-Klein K, Cutler GB: Reproductive axis after discontinuation of gonadotropin-releasing hormone analog treatment of girls with precocious puberty: long term follow-up comparing girls with hypothalamic hamartoma to those with idiopathic precocious puberty. J Clin Endocrinol Metab. 1999, 84 (1): 44-49. 10.1210/jcem.84.1.5409.CrossRefPubMed Feuillan PP, Jones JV, Barnes K, Oerter-Klein K, Cutler GB: Reproductive axis after discontinuation of gonadotropin-releasing hormone analog treatment of girls with precocious puberty: long term follow-up comparing girls with hypothalamic hamartoma to those with idiopathic precocious puberty. J Clin Endocrinol Metab. 1999, 84 (1): 44-49. 10.1210/jcem.84.1.5409.CrossRefPubMed
9.
go back to reference Van der Sluis IM, Boot AM, Krenning EP, Drop SL, de Muinck Keizer-Schrama SM: 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. 2002, 87 (2): 506-512. 10.1210/jcem.87.2.8202.CrossRefPubMed Van der Sluis IM, Boot AM, Krenning EP, Drop SL, de Muinck Keizer-Schrama SM: 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. 2002, 87 (2): 506-512. 10.1210/jcem.87.2.8202.CrossRefPubMed
10.
go back to reference Antoniazzi F, Arrigo T, Cisternino M, Galluzzi F, Bertelloni S, Pasquino AM, Borrelli P, Osio D, Mengarda F, De Luca F, Tatò L: End results in central precocious puberty with GnRH analog treatment: the data of the Italian Study Group for Physiopathology of Puberty. J Pediatr Endocrinol Metab. 2000, 13 (Suppl 1): 773-780.PubMed Antoniazzi F, Arrigo T, Cisternino M, Galluzzi F, Bertelloni S, Pasquino AM, Borrelli P, Osio D, Mengarda F, De Luca F, Tatò L: End results in central precocious puberty with GnRH analog treatment: the data of the Italian Study Group for Physiopathology of Puberty. J Pediatr Endocrinol Metab. 2000, 13 (Suppl 1): 773-780.PubMed
11.
go back to reference Arrigo T, De Luca F, Antoniazzi F, Galluzzi F, Segni M, Rosano M, Messina MF, Lombardo F: Reduction of baseline body mass index under gonadotropin-suppressive therapy in girls with idiopathic precocious puberty. Eur J Endocrinol. 2004, 150 (4): 533-537. 10.1530/eje.0.1500533.CrossRefPubMed Arrigo T, De Luca F, Antoniazzi F, Galluzzi F, Segni M, Rosano M, Messina MF, Lombardo F: Reduction of baseline body mass index under gonadotropin-suppressive therapy in girls with idiopathic precocious puberty. Eur J Endocrinol. 2004, 150 (4): 533-537. 10.1530/eje.0.1500533.CrossRefPubMed
12.
go back to reference Messaaoui A, Massa G, Tenoutasse S, Heinrichs C: [Treatment of central precocious puberty with Gonadotropin-Releasing Hormone agonist (triptorelin) in girls: breast development, skeletal maturation, height and weight evolution during and after treatment]. Rev Med Brux. 2005, 26 (1): 27-32.PubMed Messaaoui A, Massa G, Tenoutasse S, Heinrichs C: [Treatment of central precocious puberty with Gonadotropin-Releasing Hormone agonist (triptorelin) in girls: breast development, skeletal maturation, height and weight evolution during and after treatment]. Rev Med Brux. 2005, 26 (1): 27-32.PubMed
13.
go back to reference Aguiar AL, Couto-Silva AC, Vicente EJ, Freitas IC, Cruz T, Adan L: Weight evolution in girls treated for idiopathic central precocious puberty with GnRH analogues. J Pediatr Endocrinol Metab. 2006, 19 (11): 1327-1334.CrossRefPubMed Aguiar AL, Couto-Silva AC, Vicente EJ, Freitas IC, Cruz T, Adan L: Weight evolution in girls treated for idiopathic central precocious puberty with GnRH analogues. J Pediatr Endocrinol Metab. 2006, 19 (11): 1327-1334.CrossRefPubMed
14.
go back to reference Glab E, Barg E, Wikiera B, Grabowski M, Noczynska A: Influence of GnRH analog therapy on body mass in central precocious puberty. Pediatr Endocrinol Diabetes Metab. 2009, 15 (1): 7-11.PubMed Glab E, Barg E, Wikiera B, Grabowski M, Noczynska A: Influence of GnRH analog therapy on body mass in central precocious puberty. Pediatr Endocrinol Diabetes Metab. 2009, 15 (1): 7-11.PubMed
15.
go back to reference Chiocca E, Dati E, Baroncelli GI, Mora S, Parrini D, Erba P, Bertelloni S: Body mass index and body composition in adolescents treated with gonadotropin-releasing hormone analogue triptorelin depot for central precocious puberty: data at near final height. Neuroendocrinology. 2009, 89 (4): 441-447. 10.1159/000197862.CrossRefPubMed Chiocca E, Dati E, Baroncelli GI, Mora S, Parrini D, Erba P, Bertelloni S: Body mass index and body composition in adolescents treated with gonadotropin-releasing hormone analogue triptorelin depot for central precocious puberty: data at near final height. Neuroendocrinology. 2009, 89 (4): 441-447. 10.1159/000197862.CrossRefPubMed
16.
go back to reference Ko JH, Lee HS, Lim JS, Kim SM, Hwang JS: Changes in bone mineral density and body composition in children with central precocious puberty and early puberty before and after one year of treatment with GnRH agonist. Horm Res Paediatr. 2011, 75 (3): 174-179. 10.1159/000320039.CrossRefPubMed Ko JH, Lee HS, Lim JS, Kim SM, Hwang JS: Changes in bone mineral density and body composition in children with central precocious puberty and early puberty before and after one year of treatment with GnRH agonist. Horm Res Paediatr. 2011, 75 (3): 174-179. 10.1159/000320039.CrossRefPubMed
17.
go back to reference Magiakou MA, Manousaki D, Papadaki M, Hadjidakis D, Levidou G, Vakaki M, Papaefstathiou A, Lalioti N, Kanaka-Gantenbein C, Piaditis G, Chrousos GP, Dacou-Voutetakis C: 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. 2010, 95 (1): 109-117. 10.1210/jc.2009-0793.CrossRefPubMed Magiakou MA, Manousaki D, Papadaki M, Hadjidakis D, Levidou G, Vakaki M, Papaefstathiou A, Lalioti N, Kanaka-Gantenbein C, Piaditis G, Chrousos GP, Dacou-Voutetakis C: 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. 2010, 95 (1): 109-117. 10.1210/jc.2009-0793.CrossRefPubMed
18.
go back to reference Chiavaroli V, Liberati M, D'Antonio F, Masuccio F, Capanna R, Verrotti A, Chiarelli F, Mohn A: GNRH analog therapy in girls with early puberty is associated with the achievement of predicted final height but also with increased risk of polycystic ovary syndrome. Eur J Endocrinol. 2010, 163 (1): 55-62. 10.1530/EJE-09-1102.CrossRefPubMed Chiavaroli V, Liberati M, D'Antonio F, Masuccio F, Capanna R, Verrotti A, Chiarelli F, Mohn A: GNRH analog therapy in girls with early puberty is associated with the achievement of predicted final height but also with increased risk of polycystic ovary syndrome. Eur J Endocrinol. 2010, 163 (1): 55-62. 10.1530/EJE-09-1102.CrossRefPubMed
19.
go back to reference Lazar L, Kauli R, Pertzelan A, Phillip M: Gonadotropin-suppressive therapy in girls with early and fast puberty affects the pace of puberty but not total pubertal growth or final height. J Clin Endocrinol Metab. 2002, 87 (5): 2090-2094. 10.1210/jcem.87.5.8481.CrossRefPubMed Lazar L, Kauli R, Pertzelan A, Phillip M: Gonadotropin-suppressive therapy in girls with early and fast puberty affects the pace of puberty but not total pubertal growth or final height. J Clin Endocrinol Metab. 2002, 87 (5): 2090-2094. 10.1210/jcem.87.5.8481.CrossRefPubMed
20.
go back to reference Sorensen K, Mouritsen A, Mogensen SS, Aksglaede L, Juul A: Insulin sensitivity and lipid profiles in girls with central precocious puberty before and during gonadal suppression. J Clin Endocrinol Metab. 2010, 95 (8): 3736-3744. 10.1210/jc.2010-0731.CrossRefPubMed Sorensen K, Mouritsen A, Mogensen SS, Aksglaede L, Juul A: Insulin sensitivity and lipid profiles in girls with central precocious puberty before and during gonadal suppression. J Clin Endocrinol Metab. 2010, 95 (8): 3736-3744. 10.1210/jc.2010-0731.CrossRefPubMed
21.
go back to reference Carel JC, Eugster EA, Rogol A, Ghizzoni L, Palmert MR, Antoniazzi F, Berenbaum S, Bourguignon JP, Chrousos GP, Coste J, Deal S, de vries L, Foster C, Heger S, Holland J, Jahnukainen K, Juul A, Kaplowitz P, Lahlou N, Lee MM, Lee P, Merke DP, Neely EK, Oostdijk W, Phillip M, Rosenfield RL, Shulman D, Styne D, Tauber M, Wit JM, Tauber M: Consensus statement on the use of gonadotropin-releasing hormone analogs in children. Pediatrics. 2009, 123 (4): e752-e762. 10.1542/peds.2008-1783.CrossRefPubMed Carel JC, Eugster EA, Rogol A, Ghizzoni L, Palmert MR, Antoniazzi F, Berenbaum S, Bourguignon JP, Chrousos GP, Coste J, Deal S, de vries L, Foster C, Heger S, Holland J, Jahnukainen K, Juul A, Kaplowitz P, Lahlou N, Lee MM, Lee P, Merke DP, Neely EK, Oostdijk W, Phillip M, Rosenfield RL, Shulman D, Styne D, Tauber M, Wit JM, Tauber M: Consensus statement on the use of gonadotropin-releasing hormone analogs in children. Pediatrics. 2009, 123 (4): e752-e762. 10.1542/peds.2008-1783.CrossRefPubMed
22.
go back to reference Chen SK, Fan X, Tang Q: [Impact of gonadotropin-releasing hormone analogs treatment on final height in girls with central precocious puberty]. Zhongguo Dang Dai Er Ke Za Zhi. 2009, 11 (5): 374-376.PubMed Chen SK, Fan X, Tang Q: [Impact of gonadotropin-releasing hormone analogs treatment on final height in girls with central precocious puberty]. Zhongguo Dang Dai Er Ke Za Zhi. 2009, 11 (5): 374-376.PubMed
23.
go back to reference Boot AM, De Muinck K-SS, Pols HA, Krenning EP, Drop SL: Bone mineral density and body composition before and during treatment with gonadotropin-releasing hormone agonist in children with central precocious and early puberty. J Clin Endocrinol Metab. 1998, 83 (2): 370-373.PubMed Boot AM, De Muinck K-SS, Pols HA, Krenning EP, Drop SL: Bone mineral density and body composition before and during treatment with gonadotropin-releasing hormone agonist in children with central precocious and early puberty. J Clin Endocrinol Metab. 1998, 83 (2): 370-373.PubMed
24.
go back to reference Bridges NA, Cooke A, Healy MJ, Hindmarsh PC, Brook CG: Standards for ovarian volume in childhood and puberty. Fertil Steril. 1993, 60 (3): 456-460.PubMed Bridges NA, Cooke A, Healy MJ, Hindmarsh PC, Brook CG: Standards for ovarian volume in childhood and puberty. Fertil Steril. 1993, 60 (3): 456-460.PubMed
25.
go back to reference National Center for Health Statistics and National Center for Chronic Disease Prevention and Health promotion: CDC Growth chart. 2000 National Center for Health Statistics and National Center for Chronic Disease Prevention and Health promotion: CDC Growth chart. 2000
26.
go back to reference Mendez Castellano H, López M, Benaim G, Maza D, González I: Estudio nacional de crecimiento y desarrollo humano de la Republica de Venezuela, Proyecto Venezuela. 1996, Fundacredesa Mendez Castellano H, López M, Benaim G, Maza D, González I: Estudio nacional de crecimiento y desarrollo humano de la Republica de Venezuela, Proyecto Venezuela. 1996, Fundacredesa
27.
go back to reference Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972, 18 (6): 499-502.PubMed Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972, 18 (6): 499-502.PubMed
28.
go back to reference Quijada Z, Paoli M, Zerpa Y, Camacho N, Cichetti R, Villarroel V, Arata-Bellabarba G, Lanes R, Arata-Bellabarba G, Lanes R: The triglyceride/HDL-cholesterol ratio as a marker of cardiovascular risk in obese children; association with traditional and emergent risk factors. Pediatr Diabetes. 2008, 9 (5): 464-71. 10.1111/j.1399-5448.2008.00406.x.CrossRefPubMed Quijada Z, Paoli M, Zerpa Y, Camacho N, Cichetti R, Villarroel V, Arata-Bellabarba G, Lanes R, Arata-Bellabarba G, Lanes R: The triglyceride/HDL-cholesterol ratio as a marker of cardiovascular risk in obese children; association with traditional and emergent risk factors. Pediatr Diabetes. 2008, 9 (5): 464-71. 10.1111/j.1399-5448.2008.00406.x.CrossRefPubMed
29.
go back to reference Lee JM, Appugliese D, Kaciroti N, Corwyn RF, Bradley RH, Lumeng JC: Weight status in young girls and the onset of puberty. Pediatrics. 2007, 119 (3): e624-30. 10.1542/peds.2006-2188.CrossRefPubMed Lee JM, Appugliese D, Kaciroti N, Corwyn RF, Bradley RH, Lumeng JC: Weight status in young girls and the onset of puberty. Pediatrics. 2007, 119 (3): e624-30. 10.1542/peds.2006-2188.CrossRefPubMed
30.
go back to reference Davison KK, Susman EJ, Birch LL: Percent body fat at age 5 predicts earlier pubertal development among girls at age 9. Pediatrics. 2003, 111 (4 Pt 1): 815-21.PubMedCentralCrossRefPubMed Davison KK, Susman EJ, Birch LL: Percent body fat at age 5 predicts earlier pubertal development among girls at age 9. Pediatrics. 2003, 111 (4 Pt 1): 815-21.PubMedCentralCrossRefPubMed
31.
go back to reference Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH: Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997, 337 (13): 869-73. 10.1056/NEJM199709253371301.CrossRefPubMed Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH: Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997, 337 (13): 869-73. 10.1056/NEJM199709253371301.CrossRefPubMed
Metadata
Title
Higher prevalence of obesity and overweight without an adverse metabolic profile in girls with central precocious puberty compared to girls with early puberty, regardless of GnRH analogue treatment
Authors
Ana Colmenares
Peter Gunczler
Roberto Lanes
Publication date
01-12-2014
Publisher
BioMed Central
Published in
International Journal of Pediatric Endocrinology / Issue 1/2014
Electronic ISSN: 1687-9856
DOI
https://doi.org/10.1186/1687-9856-2014-5

Other articles of this Issue 1/2014

International Journal of Pediatric Endocrinology 1/2014 Go to the issue