Insulin Sensitivity in Girls with Central Precocious Puberty at Diagnosis and at 6 Months of GnRH Analogue Treatment

ARCARI, ANDREA; BALLERINI, MARÍA GABRIELA; GRYNGARTEN, MIRTA; ESCOBAR, MARÍA EUGENIA; BERGADÁ, IGNACIO; FREIRE, ANALIA; ROPELATO, MARÍA GABRIELA

Buenos Aires

Congreso; XXVI Congreso de la Sociedad Latinoamericana de Endocrinología Pediátrica.; 2016

Sociedad Latinoamericana de Endocrinología Pediátrica.

Background: Puberty is associated with a physiological declinein insulin sensitivity. Overweight and obesity are common amonggirls with Central Precocious Puberty (CPP). CPP and early menarchehave been considered as risk factors for obesity and cardiovasculardiseases during adulthood. Besides, concern has beenraised by the potential impact of GnRH analogues (GnRH-a) treatmenton body weight and metabolic profile.Objective and Hypotheses: To evaluate BMI and metabolicparameters in CPP girls at diagnosis and during GnRHa treatment.Method: We performed a cross sectional and prospective longitudinalstudy of 15 CPP girls at diagnosis and at 6 months onGnRHa therapy with an oral glucose tolerance test (OGTT). Glucoseand insulin levels were measured at 0, 30, 60, 90 and 120 minutes.Fasting lipid profile was also evaluated. Surrogates indices forfasting (SFI) insulin resistance (IR) [HOMA-IR, G/I, QUICKI]were calculated and evaluated according to own local cutoff. MatsudaIndex 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 normalweight, whereas 7 were overweight (OW) or obese (Ob). Nosignificant change in BMI was observed between baseline and ontreatment. Six patients had at least 2 impaired indices for insulinsensitivity (three of them had normal weight) and 2 patients onlyone. During OGTT 5 patients with OW or Ob showed hyperinsulinemia.Few patients had dyslipidemia. Matsuda index was low in3 patients at diagnosis. There were not significant changes in SFIand during OGTT between diagnosis and on GnRHa treatment.Conclusion: Our cohort of CPP girls showed a high frequencyof OW and Ob as well as high frequency of IR. BMI and metabolicprofile did not show changes at six month of GnRHa treatment.Further studies will be necessary to determine long term metabolicrisk in these patients.