Do GnRH Analogues Cause Weight Gain in Girls Diagnosed with Central Precocious Puberty?

Öz

Background: Gonadotropin-releasing hormone analogues (GnRHa) have been widely used in the treatment of patients with central precocious puberty (CPP) for many years. In previous studies regarding the effects of GnRHa therapy on body mass index (BMI), conflicting results have been obtained. In this study, it was aimed to evaluate the effects of GnRHa therapy on BMI in girls diagnosed with CPP. Material and method: In the study, a total of 145 female patients, who were treated and followed up due to CPP between September 2016 and June 2021, were included. In the retrospective review of medical records of the patients, age at admission, height, weight, BMI and standard deviation scores (SDS), bone age, Tanner stage, serum follicle-stimulating hormone (FSH) levels, luteinizing hormone (LH) levels, estradiol (E2) levels and the peak LH level in the GnRH stimulation test in the beginning and after the first year of treatment were evaluated. Results: The mean age of 145 patients with central precocious puberty in the beginning of treatment was 7.27±0.97 years, and the mean bone age was 9.12±1.10 years. In the beginning of treatment, 118 (81.38%) of the patients were at a normal weight or underweight, and 27 (18.62%) patients were overweight or obese. 109 (75.17%) of the patients were in Tanner stage 2, 30 (20.69%) patients were in Tanner stage 3, and 6 (4.14%) patients were in Tanner stage 4. While the mean BMI-SDS of all patients was 0.11±0.99 before the treatment, it increased significantly (p<0.01) in the first year of treatment and was found as 0.35 ± 0.95. While the mean BMI-SDS of patients who were at a normal weight or underweight was -0.21± 0.78 before the treatment, it was found as 0.09±0.84 after the treatment (p < 0.01). The initial BMI-SDS of overweight or obese patients was 1.53±0.40, and it was found as 1.48±0.49 after the treatment (p=0.41). Conclusion: In our study, it was shown that GnRHa therapy used in the treatment of central precocious puberty increased the BMI-SDS in patients who were at a normal weight or underweight, but it did not cause any change in patients who were overweight or obese.

Anahtar Kelimeler

• Central Precocious Puberty
• Body Mass Index
• Gonadotropin-Releasing Hormone

Santral Puberte Prekoks Tanısı Konulan Kız Çocuklarında GnRH Analogları Kilo Artışı Yapar mı?

Öz

Amaç: Gonadotropin-releasing hormone analogları (GnRHa), uzun yıllardır santral puberte prekokslu (SPP) hastaların tedavisinde yaygın olarak kullanılmaktadır. Önceki çalışmalarda GnRHa tedavisinin vücut kitle indeksi (VKİ) üzerindeki etkileri ile ilişkili çelişkili sonuçlar mevcuttur.Bu çalışmada SPP tanısı konulan kız çocuklarında GnRHa tedavisinin VKİ üzerindeki etkisinin değerlendirilmesi amaçlanmıştır. Materyal ve metod: Çalışmaya Eylül 2016 – Haziran 2021 tarihleri arasında SPP nedeniyle izlenen ve tedavi edilen toplam 145 kız hasta alındı. Olguların geriye dönük dosya kayıtlarında; başvuru anındaki yaşı, başlangıç ve tedavinin birinci yılındaki boy, kilo, VKİ ve standart deviasyon skorları (SDS), kemik yaşı, Tanner evresi, serum folikül uyarıcı hormon (FSH), lüteinizan hormon (LH), östradiol (E2) seviyeleri ve GnRH stimülasyon testi sırasındaki pik LH seviyesi değerlendirildi. Bulgular: Santral puberte prekoks saptanan 145 hastanın tedavi başlangıcındaki yaş ortalaması 7.27±0.97 yıl, ortalama kemik yaşı 9.12±1.10 yıl idi. Tedavi başlangıcında 118 (% 81.38) hasta normal veya düşük kilolu, 27 (% 18.62) hasta ise kilolu yada obezdi. 109 (%75.17) olgu tanner evre 2, 30 olgu (% 20.69) tanner evre 3 ve 6 olgu (% 4.14) ise tanner evre 4’te idi. Tüm hastaların tedavi öncesi ortalama VKİ-SDS’si 0,11±0,99 iken, tedavinin birinci yılında 0.35 ± 0.95 olarak bulundu ve anlamlı ölçüde artış saptandı (p<0.01). Normal veya düşük kilolu hastaların tedavi öncesi ortalama VKİ-SDS’si -0.21± 0.78 iken, tedavi sonrası 0.09±0.84 saptandı (p < 0.01). Kilolu veya obez hastaların başlangıç VKİ-SDS’si 1.53±0.40 iken, tedavi sonrası 1.48±0.49 saptandı (p=0.41). Sonuç: Çalışmamızda santral puberte prekoks tedavisinde kullanılan GnRHa tedavisinin zayıf ve normal kilolu olgularda VKİ-SDS’sini artırdığı, fazla kilolu veya obez grupta ise değişikliğe yol açmadığı gösterilmiştir.

Anahtar Kelimeler

• Santral puberte prekoks
• Vücut kitle indeksi
• Gonadotropin-releasing hormone

Kaynakça

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