Body composition in girls during and after GnRH analog therapy : Long-term follow-up

Objective: To evaluate body mass index (BMI) evolution and obesity prevalence in a large cohort of girls with idiopathic central precocious puberty (ICPP) who were treated with gonadotropin-releasing hormone agonists (GnRHa) for at least 2 years. Patients: 101 girls with ICPP were treated for 44 ± 14 months and followed for 15.7 ± 7.8 months after therapy withdrawal. Results: At the start of therapy 23.8% of the girls were obese (BMI >2 SDS); both average BMI SDS and obesity prevalence significantly decreased during the treatment period (Χ 2 = 16.6, p <0.0005), and only 4% of the patients, all with pre-existing obesity, were still obese at the end of therapy. Both average BMI SDS and obesity prevalence (from 4% to 0%; Χ 2 = 4.0, p <0.05) decreased further during the period that followed therapy withdrawal. Conclusions: a) girls with ICPP may frequently be obese at the onset of GnRHa therapy, probably due to the hormonal changes which accompany puberty start; b) their obesity is neither long-lasting nor related to GnRHa administration; c) GnRHa therapy may have, on the contrary, a favorable effect on BMI decrease, provided that treatment is administered for at least 2 years and is accompanied by complete suppression of gonadotropin secretion.