Background: Gonadotropin-releasing hormone analog (GnRHa) is the gold standard treatment for central precocious puberty (CPP). In recent years, increased prevalence of polycystic ovary syndrome (PCOS) has been reported in girls treated with GnRHa for CPP. Attributes of PCOS overlap normal pubertal changes, making the diagnosis of PCOS during adolescence controversial.
Aim: To assess the metabolic profile, the prevalence of PCOS and describe its phenotypes as function of different combination of diagnostic criteria in young girls treated with GnRHa for CPP.
Methods: We evaluated 22 girls treated with GnRHa for CPP, who were at least 2 years after menarche and had attained near final height. We assessed auxological parameters, lipid profile, markers of insulin resistance, androgen levels, and the prevalence of PCOS and PCOS phenotypes.
Results: GnRHa-treated patients attained predicted final height. Mean standard deviation score (SDS) for height was −0.39±0.7 versus target height (SDS). Mean gynecological age at evaluation was 3.06±1 years. Among PCOS criteria, hyperandrogenemia was found in 38% of patients, 33% had clinical hyperandrogenism, 24% had menstrual disturbances (oligomenorrhea, secondary amenorrhea), and 28% percent had polycystic ovary morphology on ultrasound examination. A total of 19% of cases had PCOS according to Pediatric Endocrine Society 2015 consensus on PCOS diagnosis during adolescence; according to Rotterdam criteria. 33% of girls had PCOS. No predictive factors of PCOS were found at the time of ICPP diagnosis in our series. Among clinical, metabolic and hormonal parameters, the differences between non-PCOS and PCOS girls were at the limit of statistical significance. Only LH values were statistically significant between the 2 groups
Conclusions: Patients with CCP treated with GnRHa need to be followed-up for PCOS in adolescence in order to establish whether the condition persists in young adulthood, due to its implications on fertility and metabolic complications.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology