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Gonadotropin releasing hormone analogue therapy in girls with idiopathic precocious puberty/early-fast puberty: dynamics in adiposity indices, eating habits and quality of life

  • Shiran Abargil Loochi , Sharon Demol , Nessia Nagelberg , Yael Lebenthal , Moshe Phillip and Michal Yackobovitch-Gavan EMAIL logo
Published/Copyright: February 22, 2021
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 34 Issue 3

Abstract

Background

The impact of gonadotropin-releasing-hormone-analogue (GnRHa) treatment on weight and body composition is controversial. Exploring the nutritional, psychological patterns of this population may aid to clarify this propensity to gain weight. This prospective observational study aimed to evaluate longitudinal changes in adiposity, nutrition and quality of life in girls with central precocious/early-fast puberty (CPP/EFP) during GnRHa treatment.

Methods

Thirty-two GnRHa-treated girls with CPP/EFP and 27 prepubertal girls (7–10 years) were included in the analysis. Outcome measures assessed at baseline for CPP/EFP and the control groups and during up to two years of GnRHa treatment for the CPP/EFP group, included anthropometrics, body-composition, basal-metabolic-rate (BMR), 3-day food-diaries, child eating-behavior questionnaire, and pediatric quality-of-life questionnaire (PedsQL).

Results

Girls with CPP/EFP had higher pretreatment BMI-SDS, fat percentages, waist circumference and waist-per-height (p<0.01 for all), and lower psychosocial functioning than controls (p<0.05). Changes in anthropometric and body composition measurements indicated a gradual increase in adiposity and a decrease in muscle mass (p<0.001 for all). Dynamics in body composition could not be explained by the participants’ self-reported dietary patterns and physical activity levels or by the measured BMR, which revealed an adequate and relatively low energy intake as compared to energy requirements. A gradual decline in physical functioning (PedsQL) after one and two years of GnRHa treatment was observed (p<0.001).

Conclusions

Our findings highlight the need for comprehensive surveillance in girls with CPP/EFP. Dynamics in weight status and body composition during GnRHa treatment indicate the need for tailored nutritional and physical activity counseling aimed at preventing obesity.

Keywords: body composition; central precocious puberty; gonadotropin-releasing hormone analogue treatment; nutritional assessment; quality of life
Corresponding author: Michal Yackobovitch-Gavan, Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, 14 Kaplan St., Petah Tikva49202-35, Israel, E-mail:
Shiran Abargil Loochi and Sharon Demol contributed equally to this work.

Acknowledgements

The authors thank Ruth Fradkin for editorial assistance. The authors thank the participating children and their families who made this study possible. Appreciation is also expressed to our research coordinators and to the study nurses. Parts of this data were presented in poster form at the sixth International Conference on Nutrition & Growth, March 2019, Valencia, Spain.

  1. Research funding: None declared.

  2. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  3. Competing interests: Authors state no conflict of interest.

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Received: 2020-08-10
Accepted: 2021-01-02
Published Online: 2021-02-22
Published in Print: 2021-03-26

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review Article
  3. Inborn errors of immunity and metabolic disorders: current understanding, diagnosis, and treatment approaches
  4. Original Articles
  5. Evaluation of hydration status of children with obesity—a pilot study
  6. Relationship between insulin-like growth factor-1, insulin resistance and metabolic profile with pre-obesity and obesity in children
  7. Evaluation of Hemoglobin A1c before and after initiation of continuous glucose monitoring in children with type 1 diabetes mellitus
  8. Karyotype is associated with timing of ovarian failure in women with Turner syndrome
  9. The role of makorin ring finger protein-3, kisspeptin, and neurokinin B in the physiology of minipuberty
  10. Brain MRIs may be of low value in most children diagnosed with isolated growth hormone deficiency
  11. Significant improvement in bone mineral density in pediatric celiac disease: even at six months with gluten-free diet
  12. Population-based waist circumference reference values in Japanese children (0–6 years): comparisons with Dutch, Swedish and Turkish preschool children
  13. Extended growth charts for Indian children
  14. Rib fractures in infancy, case-series and register case-control study from Sweden
  15. Gonadotropin releasing hormone analogue therapy in girls with idiopathic precocious puberty/early-fast puberty: dynamics in adiposity indices, eating habits and quality of life
  16. Case Reports
  17. Transient benign hyperphosphatasemia due to COVID-19: the first case report
  18. ATP synthase deficiency due to m.8528T>C mutation – a novel cause of severe neonatal hyperammonemia requiring hemodialysis
  19. IgG4-related hypophysitis in adolescence
  20. Graves’ disease in a five-month-old boy with an unusual treatment course
  21. Oral sodium phenylbutyrate for hyperammonemia associated with congenital portosystemic shunt: a case report
  22. Severe multisystem organ dysfunction in an adolescent with simultaneous presentation of Addison’s and Graves’ disease
https://doi.org/10.1515/jpem-2020-0471
Keywords for this article
body composition; central precocious puberty; gonadotropin-releasing hormone analogue treatment; nutritional assessment; quality of life

Articles in the same Issue

  1. Frontmatter
  2. Review Article
  3. Inborn errors of immunity and metabolic disorders: current understanding, diagnosis, and treatment approaches
  4. Original Articles
  5. Evaluation of hydration status of children with obesity—a pilot study
  6. Relationship between insulin-like growth factor-1, insulin resistance and metabolic profile with pre-obesity and obesity in children
  7. Evaluation of Hemoglobin A1c before and after initiation of continuous glucose monitoring in children with type 1 diabetes mellitus
  8. Karyotype is associated with timing of ovarian failure in women with Turner syndrome
  9. The role of makorin ring finger protein-3, kisspeptin, and neurokinin B in the physiology of minipuberty
  10. Brain MRIs may be of low value in most children diagnosed with isolated growth hormone deficiency
  11. Significant improvement in bone mineral density in pediatric celiac disease: even at six months with gluten-free diet
  12. Population-based waist circumference reference values in Japanese children (0–6 years): comparisons with Dutch, Swedish and Turkish preschool children
  13. Extended growth charts for Indian children
  14. Rib fractures in infancy, case-series and register case-control study from Sweden
  15. Gonadotropin releasing hormone analogue therapy in girls with idiopathic precocious puberty/early-fast puberty: dynamics in adiposity indices, eating habits and quality of life
  16. Case Reports
  17. Transient benign hyperphosphatasemia due to COVID-19: the first case report
  18. ATP synthase deficiency due to m.8528T>C mutation – a novel cause of severe neonatal hyperammonemia requiring hemodialysis
  19. IgG4-related hypophysitis in adolescence
  20. Graves’ disease in a five-month-old boy with an unusual treatment course
  21. Oral sodium phenylbutyrate for hyperammonemia associated with congenital portosystemic shunt: a case report
  22. Severe multisystem organ dysfunction in an adolescent with simultaneous presentation of Addison’s and Graves’ disease
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