Long-term outcomes of gonadotropin-releasing hormone analogue-treated obese girls with central precocious puberty

Natee Sakornyutthadej; Jirawat Pruksasri; Pat Mahachoklertwattana; Sarunyu Pongratanakul; Orapan Upakankul; Preamrudee Poomthavorn

doi:10.1530/endoabs.110.P932

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Endocrine Abstracts (2025) 110 P932 | DOI: 10.1530/endoabs.110.P932

ECEESPE2025 Poster Presentations Pituitary, Neuroendocrinology and Puberty (162 abstracts)

Long-term outcomes of gonadotropin-releasing hormone analogue-treated obese girls with central precocious puberty

Natee Sakornyutthadej ¹ , Jirawat Pruksasri ² , Pat Mahachoklertwattana ² , Sarunyu Pongratanakul ² , Orapan Upakankul ² & Preamrudee Poomthavorn ²

Author affiliations

¹Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand; ²Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

JOINT2285

Background: Both central precocious puberty (CPP) and obesity cause advanced bone maturation and accelerated growth. Gonadotropin-releasing hormone analogue (GnRHa) is the standard treatment for preserving final height (FH) potential in girls with CPP. It is unclear whether GnRHa-treated obese girls with CPP achieve less favorable FH outcomes as compared with non-obese girls.

Objective: To study long-term outcomes of obese girls with idiopathic CPP (iCPP) who were treated with GnRHa in comparison with those with normal weight.

Methods: Medical records of 233 obese and 334 normal-weight girls with iCPP who had been treated with either monthly or 3-monthly leuprolide or triptorelin acetate, and attained FH at Ramathibodi Hospital, Thailand, between 2007 and 2024 were reviewed. Long-term outcomes of GnRHa treatment, focusing on FH, height gain (FH – pre-treatment predicted adult height), time to menarche after GnRHa discontinuation and body mass index (BMI) were collected and compared between obese and normal-weight iCPP girls.

Results: Medians (IQRs) age at diagnosis of obese and normal-weight iCPP girls were 7.5 (7.0, 7.8) and 7.5 (7.1, 7.8) years, respectively (p=0.304). Mid-parental height (MPH) was not different between both groups. At diagnosis, obese girls with iCPP were taller (height SDS: 1.53 (0.70, 2.20) vs. 0.85 (0.18, 1.43), p<0.001) and had more bone age (BA) advancement (2.5 (1.8, 3.2) vs. 1.9 (1.1, 2.6) years, p<0.001). GnRHa treatment was started and discontinued at 8.3 (7.8, 8.7) and 11.5 (10.7, 12.1), and 8.2 (7.8, 8.8) and 11.7 (11.0, 12.5) years of age in obese and normal-weight girls, respectively. BA at treatment discontinuation was not different between groups. Compared with normal-weight girls, obese girls had greater height gain (8.6 (5.9, 11.8) vs. 7.4 (4.7, 10.4) cm, p=0.012), and FH SDS (0.42 (-0.24, 0.99) vs. 0.15 (-0.40, 0.69), p=0.002). Duration from GnRHa discontinuation to menarche of obese girls was less than that of normal-weight girls (12.0 (8.4, 18.0) vs. 14.4 (9.6, 20.4) months, p=0.012). BMI SDSs at FH were significantly lower than those at diagnosis in both groups (obese: 1.17 (0.53, 2.07) vs. 1.77 (1.31, 2.59), p<0.001, normal-weight: -0.32 (-0.96, 0.30) vs. 0.21 (-0.38, 0.61), p<0.001).

Conclusions: Despite having greater BA advancement at diagnosis, obese girls achieved greater height gain and FH than normal-weight girls who had comparable MPH, suggesting greater height at diagnosis might compensate for FH attainment. Menstruation began earlier in obese girls following GnRHa discontinuation. BMI SDSs decreased from diagnosis to FH in both groups.