Endocrine Abstracts

JOINT2640

Context: Obesity and central precocious puberty (CPP) are linked, especially in girls, but its impact on CPP progression and treatment remains unclear.

Objectives: To assess obesity frequency in girls with CPP, analyze BMI evolution during GnRH analog treatment, and compare CPP parameters between eutrophic and overweight girls.

Methods: Data from 80 girls diagnosed with CPP and treated with GnRH analogs were analyzed (April 2017–November 2024). Anthropometric data, bone age, and pubertal staging were collected at diagnosis, treatment initiation, annually during treatment, at discontinuation, and after menarche. Height and BMI were expressed as z-scores (WHO, 2007).

Results: At diagnosis, 50% of patients were overweight. Mean (SD) zBMI was 1.1 (1.2) at diagnosis and 1.3 (1.1) at treatment discontinuation (P = 0.067). Girls were classified as eutrophic or overweight. zBMI increased only in eutrophic girls (0.455 vs. 0.585; P = 0.012). Thelarche age was similar (6.5 vs. 6.0 years; P = 0.43), but eutrophic girls had a shorter interval between thelarche and GnRH initiation (1.4 vs. 2.0 years; P < 0.001). At treatment initiation, overweight girls had higher height z-scores (1.8 vs. 1.0; P = 0.003). No differences were found in treatment initiation age (7.9 vs. 8.0 years; P = 0.655), GnRH discontinuation age (10.0 vs. 9.8 years; P = 0.164), or menarche age (11.3 vs. 10.8 years; P = 0.320). However, overweight girls had a greater difference between bone age and chronological age at treatment initiation (2.9 vs. 2.3 years; P = 0.011).

Conclusions: While no overall zBMI change occurred during GnRH treatment, eutrophic girls showed an increase. Despite similar thelarche ages, eutrophic girls started pubertal blockade earlier. Overweight girls had a greater bone age-chronological age difference, and their later treatment initiation may predict greater height loss. No differences were found in treatment discontinuation or menarche age. Further studies assessing final height are needed to evaluate the height loss risk in overweight patients.

Keywords: central precocious puberty, obesity, BMI, GnRH.

Abbreviations: CPP, central precocious puberty; BMI, body mass index; GnRH, gonadotropin-releasing hormone; SD, standard deviation.