Long-Term Observation Of Girls With Idiopathic Central Precocious Puberty Treated With GnRH Analogs: Impacts On Height And Body Mass Index

Objective:We assessed in a unicenter study the impact of treatment with GnRHa on BMI and height in girls with idiopathic central precocious puberty (ICPP).Methods:Fifty-seven ICPP girls were treated with GnRHa for 1.69±0.43 yr(range 1.0-3.17) and observed for 5.79±1.06 yr(range3.58-8.08) until they reached adult height; to estimate better,77 comparable ICPP untreated girls were analyzed, who were all diagnosed in the Affiliated Children's Hospital of Medical College of Zhejiang University. The height, weight and bone age of different periods were measured to make clear the development of the height and BMI. The treated girls with different Tanner stages were analyzed as well.Results:(1) At first observation, pretreatment BA/CA was significantly higher in the treatment group (P<0.01), meanwhile HtSDS-BA and PAHSDS were significantly lower, considering with the untreatment group. Besides, there were no differences between the groups in age, follow-up time, THSDS and BMISDS (P>0.05).(2) With the GnRHa therapy, the PAHSDS at the end of terapy and the AHSDS of the treatment group were significantly higher than the pretreatment PAHSDS (P<0.001). And with treatment the patients' AHSDS was perfect, even higher than THSDS (P<0.001). Otherwise, AHSDS of both groups were similar (P>0.05).(3) There were no significant differences between different Tanner stages.(4) At the end of treatment, the patients get weight gains, BMISDS was slightly higher than pretreatment (P>0.05), however a significant reduction was observed when they approached the adult height (P<0.001). BMI of 3 period were just lied within the normal range (-1SD,1SD). Regression analysis showed BMI for AH positively correlated with BMI at the first observation (treated group:r=0.300, P=0.031; untreated group:r=0.475, P<0.001). The rate of overweight and obesity in 77 girls untreated had no significant change after several years until they got the AH (P>0.05), while positive reduction was showed in the treated girls (P<0.001). And GnRHa therapy was the most important factor impacting on the BMI (F=18.408, P<0.001).Conclusions:(1) Catch-up growth was demonstrated in ICPP patients cured with GnRHa, with the majority achieving AH within target height range.(2) Not every ICPP patient needs therapy; it depends on the age at onset, the bone age, et al.(3) GnRHa therapy did not show long-term determental effects on BMI, and the BMI of there periods were totally normal. As a result, there is no need to stop GnRHa therapy when the weight changes.