Insulin sensitivity in girls with Central Precocious Puberty at diagnosis and at 6 months of GnRH analogue treatment

ARCARI AJ; FREIRE AV; ESCOBAR ME; BALLERINI MG; ROPELATO MG; GRYNGARTEN MG

Paris

Congreso; 55th Annual Meeting for the European Society for Paediatric Endocrinology (ESPE 2016); 2016

European Society for Paediatric Endocrinology

Background: Puberty is associated with aphysiologicaldecline in insulin sensitivity. Overweight and obesity are commonamong girls with Central Precocious Puberty (CPP). CPP andearly menarche havebeen considered as risk factors for obesityand cardiovascular diseases during adulthood. Besides, concernhas been raised by the potential impact of GnRH analogues(GnRH-a) treatment on body weight and metabolic profile.Objective and hypotheses: To evaluate BMI and metabolic parameters in CPP girls at diagnosis and during GnRHatreatment. Method: We performedacross sectionaland prospective longitudinal study of 15 CPP girls at diagnosis and at 6 monthson GnRHatherapy with an oral glucose tolerance test (OGTT). Glucose and insulin levels were measured at 0, 30, 60, 90 and 120 minutes. Fasting lipid profile was also evaluated. Surrogates indices for fasting (SFI) insulin resistance (IR) [HOMA-IR,G/I,QUICKI] were calculated and evaluated according to own localcutof f. Matsuda Index was calculated from OGTT. Results: At baseline median chronological age was 7.8 years (5.7?8.5). All girls were on Tanner stage 3. Eight patients had normal weight, whereas 7were overweight (OW) or obese (Ob). No significant change in BMI was observed between baseline and on treatment. Six patients had at least 2 impaired indices for insulin sensitivity (three of themhad normal weight) and two patients only one. During OGTT five patients with OW or Ob showed hyperinsulinemia. Few patients had dyslipidemia. Matsudaindex was low in three patients at diagnosis. There were not significant changes in SFI and during OGTT between diagnosis and on GnRHatreatment. Conclusion: Our cohort of CPP girls showed ahigh frequency of OW and Ob as well as high frequency of IR. BMI and metabolic profile did not show changes at six month of GnRHa treatment. Further studies will be necessary to determine long term metabolic risk in these patients.