Abstract
Objective
To evaluate longitudinal changes in body mass index standard deviation score (BMI SDS) in girls with central precocious puberty (CPP) treated with gonadotropin-releasing hormone analogues (GnRHa) from treatment initiation to final adult height.
Methods
This retrospective study included 150 girls with idiopathic CPP treated with leuprolide acetate and followed to final adult height. BMI SDS was assessed at treatment initiation, at 1 year of therapy, at treatment completion, and at final adult height. Patients were categorized according to BMI SDS at the time of diagnosis as underweight, normal weight, overweight, or obese. BMI SDS was evaluated at predefined time points and examined within baseline weight groups, and transitions between BMI SDS categories were analyzed across the follow-up period. In addition to baseline weight status, participants were categorized as SGA or AGA based on birth weight for gestational age.
Results
In normal-weight girls, BMI-SDS increased significantly during the first treatment year and then declined toward final height, with no difference between baseline and final height. BMI-SDS remained stable in those overweight or obese at treatment initiation. BMI-category distribution changed over follow-up (overall p = 0.014), OW+OB prevalence increased during treatment (48.6%→56.6%) and decreased by final height (45.3%) (baseline vs final p = 0.533). By final height, obesity increased (p = 0.0076) and overweight decreased (p = 0.006), while normal-weight prevalence did not differ from baseline (p = 0.098). In multivariable analysis, baseline BMI-SDS was inversely related to ΔBMI-SDS (treatment end − baseline) (β = −0.174, 95% CI −0.291 to −0.057; p = 0.004)
Conclusion
In this large cohort of girls with idiopathic CPP followed through final adult height, BMI SDS showed no sustained increase at final height across baseline weight groups, and the SGA–AGA differences observed earlier were not maintained. Baseline BMI-SDS was the key independent determinant of ΔBMI-SDS (treatment end − baseline), with lower baseline values predicting greater increases.
