ESPE Abstracts

Background: Gonadotropin releasing hormone analogs (GnRHa) are effective in improving adult height in children with precocious onset of puberty, rapid progression, and good growth potential. In last years, however, some transient metabolic complications have been described during the treatment without the reassurance of long-term data yet. The aim of our study is to clarify if body mass index (BMI) at diagnosis of idiopathic central precocious puberty (iCPP) could influence long-term anthropometric and metabolic outcomes.

Methods: This is an observational study recruiting a monocentric cohort of girls with iCPP. Anthropometric measures, bone age (BA), fasting lipid profile and glucose metabolism data (HOMA-index, fasting glucose to insulin ratio) were collected at baseline (when GnRHa started) [T0], at the end of the treatment [T1], and at near final height (nFH) [T2]. Predicted adult height (PAH) was calculated at T0 according to Bayley and Pinneau’s method. Analysis was performed according to BMI SDS categories at T0 (Group A: normal-weighted vs. Group B: over-weighted and obese girls – WHO 2007).

Results: Fifty-seven girls with iCPP treated with GnRHa were enrolled [Group A vs. B: 33 vs. 24 patients, aged at T0 7.86±0.81 vs. 7.06±1.61 years (P<0.05), BA discrepancy at T0 +1.73±1.04 vs +2.26±1.20 years (P 0.10)]. In the study population, the achieved nFH was in line with target height (TH) (-0.20±1.11 vs. -0.40±0.81 SDS, P 0.54) with a mean absolute height gain of 11.82±5.35 cm in comparison to PAH evaluated at T0. Even if in group B, the length of therapy was shorter (1.42±1.11 vs. 2.10±0.81 years, P<0.05) and their age at menarche was earlier than in group A (10.56±1.01 vs. 11.44±0.85, P<0.05), the near final height gain was comparable in the two groups (P 0.82). BMI SDS was still greater in group B than in A at nFH (0.96±1.33 vs. 0.18±0.99, P 0.012), even if BMI SDS significantly increased from T0 to T2 only in group A (P< 0.05). ANOVA analysis did not document a worsening of lipid profile and insulin resistance status in both groups from T0 to T2.

Conclusions: Our results do not support the concern that overweight and obesity could impair the long-term anthropometric outcomes of GnRHa therapy. Moreover, this treatment does not seem to deteriorate the long-term metabolic profile of patients already overweighted and obese at iCCP diagnosis.