CEDIE   05498
CENTRO DE INVESTIGACIONES ENDOCRINOLOGICAS "DR. CESAR BERGADA"
Unidad Ejecutora - UE
congresos y reuniones científicas
Título:
Insulin Sensitivity in Girls with Central Precocious Puberty at Diagnosis, 6 and 12 Months of GnRH Analogue Treatment
Autor/es:
FREIRE AV; ROPELATO MG; ARCARI AJ; BALLERINI MG; GRYNGARTEN MG; ESCOBAR ME; BERGADÁ I
Lugar:
Washington
Reunión:
Congreso; 10th International Meeting of Pediatric Endocrinology; 2017
Institución organizadora:
The global community of pediatric endocrinology
Resumen:
Objectives: To evaluate BMI and metabolic parameters in Central Precocious Puberty girls at diagnosis and during GnRHa treatment.Background: Puberty is associated with a physiological decline in insulin sensitivity (IS). Overweight and obesity are common among girls with Central Precocious Puberty (CPP). Early menarche and CPP have been considered as risk factors for long term obesity and cardiovascular diseases. Concern has been raised by the potential impact of GnRH analogues (GnRHa) treatment on body weight and metabolic profile.Methods: Prospective longitudinal study of 17 girls with CPP evaluated at diagnosis (Tanner 3; median age: 7.8 years (5.7-8.5) at 6 and 12 months on GnRHa therapy. Oral glucose tolerance test (OGTT) was performed in all of them; glucose and insulin levels (Cobas e411, Roche) were measured at 0, 30, 60, 90 and 120 minutes. Surrogates estimates of IS (HOMA-IR, G/I, QUICKI) were calculated and evaluated according to our normal local cutoff. Matsuda Index was also calculated from OGTT. Fasting lipid profile was also evaluated. ANOVA for repeated measurements was used to evaluate changes in BMI, fasting insulin and lipids throughout treatment. Results: At diagnosis, 10/17 patients were overweight (OW) or obese (OB). Six patients (3 with normal weight) had 2 impaired indices for IS (HOMA-IR and G/I). In OGTT, 5 OW/OB patients showed hyperinsulinemia. Matsuda index was low in 2 patients at diagnosis. During GnRHa treatment, no significant changes were observed in BMI, fasting insulin, or Matsuda index compared to baseline. Only four patients at diagnosis had dyslipidemia. Among them, 2 patients presented hypertriglyceridemia that persisted at the end of treatment in only one.Conclusions: Our cohort of CPP girls showed a high frequency of OW and OB as well as high prevalence of insulin resistance. GnRHa seems not to have a major impact on BMI or metabolic profile during the studied period. Further studies will be necessary to determine long term metabolic risk in these patients