Background: Puberty is associated with a physiological decline in insulin sensitivity. Overweight and obesity are common among girls with Central Precocious Puberty (CPP). CPP and early menarche have been considered as risk factors for obesity and cardiovascular diseases during adulthood. Besides, concern has been raised by the potential impact of GnRH analogues (GnRH-a) treatment on body weight and metabolic profile.
Objective and hypotheses: To evaluate BMI and metabolic parameters in CPP girls at diagnosis and during GnRHa treatment.
Method: We performed a cross sectional and prospective longitudinal study of 15 CPP girls at diagnosis and at 6 months on GnRHa therapy with an oral glucose tolerance test (OGTT). Glucose and insulin levels were measured at 0, 30, 60, 90 and 120 minutes. Fasting lipid profile was also evaluated. Surrogates indices for fasting (SFI) insulin resistance (IR) [HOMA-IR, G/I, QUICKI] were calculated and evaluated according to own local cutoff. Matsuda Index was calculated from OGTT.
Results: At baseline median chronological age was 7.8 years (5.78.5). All girls were on Tanner stage 3. Eight patients had normal weight, whereas 7 were overweight (OW) or obese (Ob). No significant change in BMI was observed between baseline and on treatment. Six patients had at least 2 impaired indices for insulin sensitivity (three of them had normal weight) and two patients only one. During OGTT five patients with OW or Ob showed hyperinsulinemia. Few patients had dyslipidemia. Matsuda index was low in three patients at diagnosis. There were not significant changes in SFI and during OGTT between diagnosis and on GnRHa treatment.
Conclusion: Our cohort of CPP girls showed a high frequency of OW and Ob as well as high frequency of IR. BMI and metabolic profile did not show changes at six month of GnRHa treatment. Further studies will be necessary to determine long term metabolic risk in these patients.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology