Systematic Review on the Increase in Body Mass Index Percentiles in Girls With Central Precocious Puberty Receiving Gonadotropin-Releasing Hormone Analogues.

AIM

To evaluate the association between gonadotropin-releasing hormone (GnRH)-analogue use and adiposity change in girls with idiopathic central precocious puberty (CPP) or early puberty (EP).

METHOD

A systematic review was performed using PubMed, Embase, Scopus, PsycInfo and Cochrane. Primary studies reporting quantitative measures of adiposity in girls with idiopathic CPP-EP who received GnRH-analogues were included. A meta-analysis was performed, with subgroup analyses based on baseline body mass index (BMI) and GnRH-analogue type.

RESULTS

There were 46 studies with 3606 girls who received GnRH-analogues. BMI-standard deviation scores (SDS) increased significantly within 2 years (0.17, 95% CI 0.12-0.23) but not beyond 2 years of therapy. Between the start and end of therapy, girls with normal BMI at baseline experienced a significant increase in BMI-SDS (0.32, 95% CI 0.22-0.42) compared to those with overweight or obesity (BMI-SDS -0.03, 95% CI -0.09 to 0.02). Leuprorelin use was associated with an increase in BMI-SDS during therapy.

CONCLUSION

GnRH-analogue use in girls with CPP-EP was associated with a transient increase in BMI-SDS during, but not beyond therapy. Girls with normal BMI at baseline had a higher risk of experiencing significant increases in BMI-SDS during therapy. BMI monitoring and anticipatory guidance for weight are recommended for those receiving GnRH-analogues.