ESPE Abstracts

Aim: Gonadotropin-releasing hormone analogues (GnRHa) are widely used in the treatment of idiopathic central precocious puberty (ICPP) cases due to premature maturation of the hypothalamus-pituitary-gonad axis. The effect of GnRHa therapy on body weight and fat distribution is controversial in the literature. We aimed to examine the anthropometric measurements and body composition analysis of the girls with ICPP and to investigate the effect of related factors on the body mass index and total body fat ratio under the GnRHa therapy.

Method: The girls who were diagnosed with ICPP and treated with GnRHa in the pediatric endocrinology clinic of our hospital between 2020 and 2022 were included in to the study. Anthropometry and body composition analysis with a bioelectrical impedance device were performed at baseline, 6th month and 12th month of the GnRHa treatment.

Results: 50 girls were included in to study. The mean age was 6.89 ± 0.62 years at the diagnosis of ICCP and the GnRHa treatment's start. Body mass index (BMI) was mean 17.39 ± 2.84 kg/m2 and BMI standard deviation score (SDS) was median 0.46 (1.52) while the BMI was mean 17.9 ± 2.73 kg/m2, BMI SDS was median 0.76 (0.97) at 6th month and BMI was mean 18.3 ± 2.89 kg/m2, BMI SDS was median 0.74 (0.74) at the 12th month of the GnRHa therapy. Increasing BMI was statistically significant during the therapy (P<0.001). The total body fat ratio was found to be increased when we compared the baseline, 6th month and 12th month (24.8 ± 5.2 %, 26.4 ± 5.3 %, 28.1 ± 5.5 %, respectively, P<0.001). On the other hand, the total lean mass ratio was found to be decreased during the therapy (71.3 ± 5.6 %, 69.3 ± 5.0 %, 68.2 ± 5.2 %, respectively, P<0.001).

Conclusion: An increase in BMI and fat mass, and a decrease in lean mass were observed during the GnRHa therapy. The decrease in lean mass observed in ICPP cases may be due to the shortening of the prepubertal growing period or the effect of the GnRHa treatment. Continued fat mass accumulation may be a consequence of the GnRHa therapy suggesting that body composition should be monitored during the therapy to prevent future obesity.