ESPE Yearbook of Paediatric Endocrinology

Brief Summary: This retrospective study of 123 Danish girls treated with GnRHa for idiopathic central precocious puberty (CPP) shows that GnRH agonists do not impact body mass index during and after cessation of treatment.

The use of GnRH agonists (GnRHa) for treatment of girls with CPP is well established but the potential long term effects of GnRHa remain a matter of debate, especially regarding their impact on weight evolution^1,2.

The aim of this study was to evaluate the effects of GnRHa on body mass index (BMI) trajectories during treatment (median 18.9 months) and after cessation of treatment (median 18.2 months). The authors postulated that effects of GnRHa treatment on BMI were correlated with baseline BMI (measured within +/- 1 month of initiation for 87% of girls) and with GnRHa treatment protocol (leuprolide acetate treatment: 4 or 3 weekly intervals with 3.75 mg or 12 or 9 weekly intervals with 11.25 mg or mixed protocol).

No overall changes in BMI SDS were observed during and after GnRHa treatment period. Girls in the lowest baseline BMI group (n=22) had a weak trend towards an ascending change in BMI SDS during treatment, while there was no clear pattern for BMI SDS changes after treatment. Overall, BMI SDS trajectories during treatment with GnRHa or after cessation of treatment were not impacted by the three dosage-interval protocols.

Those findings suggest that GnRHa treatment does not significantly impact BMI in girls with idiopathic CPP. Those results are in line with previous studies overall11However, others have reported a worsening of metabolic parameters such as insulin sensitivity under GnRHa treatment⁵. In the current study, the lack of a control group to compare treated and untreated girls with CPP is a limitation, highlighting the need for further large cohort studies to evaluate the long-term effects of GnRHa treatment on BMI and metabolic profiles.

References: 1. Corripio R, Soriano-Guillén L, Herrero FJ, et al. Changes in body mass index in girls with idiopathic central precocious puberty under gonadotropin-releasing hormone analogue therapy: the Spanish registry. Horm Res Paediatr. 2016;86(3):154-60.2. Luo X, Liang Y, Hou L, Wu W, Ying Y, Ye F. Long-term efficacy and safety of gonadotropin-releasing hormone analog treatment inchildren with idiopathic central precocious puberty: a systematic review and meta-analysis. Clin Endocrinol. 2021;94(5):786-96.3. Liang Y, Wei H, Li J, et al. Effect of GnRHa 3.75 mg subcutaneously every 6 weeks on adult height in girls with idiopathic central precocious puberty. J Pediatr Endocrinol Metab. 2015;28(7–8):839-46.4. Poomthavorn P, Suphasit R, Mahachoklertwattana P. Adult height, body mass index and time of menarche of girls with idiopathic central precocious puberty after gonadotropin- releasing hormone analogue treatment. Gynecol Endocrinol. 2011;27(8):524-8.