No adulthood metabolic consequences of central precocious puberty

By Eleanor McDermid, Senior medwireNews Reporter

Researchers have found that girls with central precocious puberty (CPP) have similar metabolic and general health to other women when they reach young to middle adulthood.

And despite being above average at diagnosis, CPP patients’ body mass index (BMI) tended to fall during adolescence and was in line with that of non-CPP women in adulthood.

“Our study would appear to lay to rest any question as to the relation of idiopathic CPP to adult obesity and metabolic outcome”, say Joseph Meyerovitch (Schneider Children’s Medical Center of Israel, Petah Tikva) and co-researchers.

Also, the CPP patients did not have an increased rate of breast or ovarian cancers, the team reports in The Journal of Clinical Endocrinology & Metabolism.

At the time of follow-up, the 142 CPP patients in the study were aged between 27 and 50 years. The CPP patients’ medical records at this time revealed similar rates of metabolic abnormalities (hyperlipidaemia, diabetes and hypertension) to those in 413 control women of similar age, and similar rates of malignancies, including oestrogen-dependent cancers.

This was the case for the 100 patients who had received gonadotropin-releasing hormone analogue (GnRHa) therapy to delay puberty and for the 42 who had not.

BMI was increased at presentation with CPP, with the GnRHa-treated group having an average BMI at percentile 61.2, in line with the recognised association between obesity and precocious puberty. The BMI of the untreated group was normal at presentation (percentile 44.7), remained so throughout adolescence and was equivalent to that of controls in adulthood.

Although increased BMI in CPP patients has been attributed to GnRHa therapy, the researchers found that treated patients’ BMIs did not significantly increase during treatment, with the patients being at percentile 63.6 by the end of therapy.

BMI fell thereafter, with patients being at percentile 46.5 by late adolescence. In adulthood, their BMI distribution was no different from that of the controls.

“Still, it is worth noting that among our treated CPP girls a higher BMI percentile at presentation and during therapy was associated with overweight and obesity at young adulthood”, say Meyerovitch et al.

But they suggest that, for these women, their increased BMI “might largely reflect the persistence of childhood obesity into adulthood”, rather than being a direct consequence of CPP or its treatment.

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