Long-Term Outcomes of Gonadotropin-Releasing Hormone Analogue Therapy in Central Precocious Puberty: A Comparative Analysis of Obese and Normal-Weight Girls.

OBJECTIVE

To determine final height (FH), body mass index (BMI) changes, and age at menarche in obese girls with idiopathic central precocious puberty (CPP) treated with gonadotropin-releasing hormone analogue (GnRHa), compared with their normal-weight counterparts.

DESIGN, PATIENTS AND MEASUREMENTS: Height outcomes, FH, BMI changes and age at menarche of girls with idiopathic CPP treated with GnRHa who had reached FH were reviewed. Comparisons were performed between the overweight/obese and normal-weight groups.

RESULTS

A total of 726 patients were enroled (269 overweight/obese and 457 normal-weight). At diagnosis, overweight/obese girls were taller (median (interquartile range) height standard deviation score (SDS): 1.53 (0.69, 2.12) versus 0.80 (0.28, 1.40), p < 0.001), and had greater degree of bone age advancement (2.5 (1.8, 3.2) vs. 2.0 (1.1, 2.7) years, p < 0.001). The overweight/obese group had greater height gain (FH-initial predicted adult height) following GnRHa treatment (8.0 (4.4, 11.5) vs. 6.8 (3.6, 10.7) cm, p = 0.010). BMI SDSs at FH were less than those at diagnosis in both groups (overweight/obese: 1.26 (0.52, 2.07) vs. 1.70 (1.23, 2.51), and normal-weight: -0.23 (-0.79, 0.47) versus 0.26 (-0.35, 0.67), p < 0.001). Notably, 109 overweight/obese girls had normalised BMI SDS at FH. The interval from GnRHa discontinuation to menarche was comparable between the two groups (14.4 (8.4, 19.2) vs. 14.4 (9.6, 19.2) months, p = 0.961).

CONCLUSIONS

GnRHa therapy had a beneficial effect on height gain in both CPP girls with overweight/obesity and normal weight. BMI SDSs at FH were less than those at diagnosis in both groups.