ESPE Abstracts (2019) 92 P2-223

Long Term Effects of GnRH Agonist Therapy on BMI in Girls with Idiopathic Central Precocious Puberty

Dogus Vuralli, Z. Alev Ozon, E. Nazli Gonc, Ayfer Alikasifoglu, Nurgun Kandemir


Hacettepe University Medical School, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey


Background: Studies investigating effects of GnRHa therapy on body weight (BW) and BMI in subjects with CPP are generally including short term effects.

Aim: To investigate changes in BMI at the beginning, during and two years after completion of GnRHa therapy to determine influential factors in girls with idiopathic CPP.

Methods: Data of 138 girls who completed GnRHa therapy for iCPP were evaluated retrospectively. All of subjects underwent weight and height measurements at beginning and end of therapy, and 111 of the study population underwent weight and height measurements two years after completion of therapy. CDC percentile curves were used for BMI assessment.

Results: Mean age of subjects at beginning of therapy was 8.5±1.0yrs, mean bone age was 10.7±0.9yrs and duration of therapy was 29.9±9.2 months. At beginning of therapy, 82(59.4%) had normal BW, 42(30.4%) were overweight, and 14(10.2%) were obese. By end of therapy, 12.2%(10/82) of subjects with normal BW had become overweight, and 2.4%(1/42) of overweight had become obese; while 92.9%(39/42) of overweight and 78.6%(11/14) of obese subjects maintained their weight. BMI-SDSs of subjects at beginning, end and two years after completion of therapy are presented in Table 1. Multivariate regression analysis revealed that among factors affecting BMI-SDS change(ΔBMI-SDS) such as age, initial BMI-SDS and duration of therapy, most significant was initial BMI-SDS, which had negative correlation with ΔBMI-SDS(r2:0.34,p:<0.001).

Conclusion: Present study is one of the unique studies evaluating BMI change over a long term of period. Although BMI-SDS increased during GnRHa therapy in normal weight girls, it was reversible in long term follow-up after therapy. However BMI-SDS did not change during and in long term follow-up after GnRHa therapy in overweight and obese girls.Conserving BMI-SDS in overweight or obese subjects during therapy may be related to the fact that BW management programs were generally recommended and applied on these subjects. Dietary recommendations should be provided for children with normal BW who undergo GnRHa therapy for CPP, as is the case for overweight patients.

Table 1.Changes in BMI-SDS during and after GnRHa therapy
All Cases
(n: 138)
Normal-Weight
(n: 82)
Overweight/Obese
(n: 56)
At the beginning of therapy0.92±0.740.42±0.541.66±0.48
At the end of therapy1.20±0.510.87±0.331.69±0.53
Two years after therapy0.90±0.620.40±0.481.65±0.52
P value<0.001<0.0010.205

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