GNRH analog therapy in girls with early puberty is associated with the achievement of predicted final height but also with increased risk of polycystic ovary syndrome.
OBJECTIVE
GNRH analog (GNRHa) therapy has not been supported by beneficial effects on adult stature in girls with early puberty. Furthermore, an increased prevalence of polycystic ovary syndrome (PCOS) has been described in girls treated for central precocious puberty. Women with PCOS are at increased risk of cardiometabolic dysfunctions and infertility. Our aim was to assess GNRHa effectiveness on reaching adult stature and the risk of PCOS in girls with early puberty.


METHODS
Longitudinal study of GNRHa-treated and GNRHa-untreated girls at baseline and at final height.


METHODS
Twenty-five GNRHa-treated girls and 55 controls were compared. Insulin resistance (IR; homeostasis model assessment of IR (HOMA-IR) and glucose-to-insulin ratio (G/I)), the effect of GNRHa on final height, and the prevalence of PCOS were assessed.


RESULTS
In GNRHa-treated girls, no significant difference was found between predicted final height and final height, whereas a significant difference was detected in untreated girls (P=0.0001). At final height, GNRHa-treated girls showed higher HOMA-IR and lower G/I (P=0.03 for both) as well as higher DHEAS and androstenedione levels (P=0.02 and P=0.01 respectively) than untreated girls. The prevalence of PCOS and hyperandrogenemia was significantly higher in GNRHa-treated adolescents than in untreated adolescents (36 and 14.5% respectively, P=0.04; 56 and 23.6% respectively, P=0.01). Finally, gonadotropin-suppressive therapy was significantly related to PCOS during adolescence (P=0.03).


CONCLUSIONS
In girls with early puberty, GNRHa therapy is associated with the achievement of predicted final height; nevertheless, this treatment seems to act as an independent risk factor for the development of PCOS already during adolescence.
Chiavaroli
Valentina
V
Departments of Pediatrics Obstetrics and Gynecology University of Chieti, Via dei Vestini 5, 66100 Chieti, Italy.
Liberati
Marco
M
D'Antonio
Francesco
F
Masuccio
Fabio
F
Capanna
Rita
R
Verrotti
Alberto
A
Chiarelli
Francesco
F
Mohn
Angelika
A
D001827:Body Height / Q000187:drug effects; D002648:Child; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D011085:Polycystic Ovary Syndrome / Q000139:chemically induced*; D011629:Puberty, Precocious / Q000188:drug therapy*
D007987:Gonadotropin-Releasing Hormone