Insulin sensitivity and lipid profiles in girls with central precocious puberty before and during gonadal suppression.
BACKGROUND
Early menarche is associated with increased risk of cardiovascular disease in adulthood. It is unknown whether metabolic risk factors are adversely affected in girls with central precocious puberty (CPP) already at time of diagnosis.


OBJECTIVE
The objective of the study was to evaluate metabolic profiles in girls with early normal puberty (EP) and CPP.


METHODS
This was a combined cross-sectional and longitudinal study at a tertiary center of pediatric endocrinology.


METHODS
Twenty-three girls with EP or CPP and 115 controls with normal pubertal timing were evaluated by oral glucose tolerance test, dual-energy x-ray absorptiometry scan, and fasting blood samples. Fifteen girls (13 CPP) were treated with GnRH agonists (GnRHa) and reevaluated after 12 and 52 wk of treatment.


METHODS
Insulin and glucose levels during oral glucose tolerance test and fasting lipid levels were measured.


RESULTS
At the time of diagnosis, girls with CPP had higher fasting insulin, triglyceride, and low-density lipoprotein-cholesterol levels as well as lower insulin sensitivity and high-density lipoprotein/total cholesterol ratios (all P<0.05) compared with controls after adjustment for pubertal stage and body fat percentage. Age at pubertal onset positively predicted insulin sensitivity for a given pubertal stage (P=0.04) in girls with EP and CPP. Insulin sensitivity decreased significantly during 1 yr of GnRHa treatment (P=0.04).


CONCLUSIONS
Girls with CPP had adverse metabolic profiles at the time of diagnosis compared with puberty-matched controls. In addition, those with the earliest onset of puberty had the most adverse metabolic profiles. Surprisingly, metabolic profiles deteriorated even further after withdrawal of sex steroids by GnRHa treatment.
Sørensen
Kaspar
K
Department of Growth and Reproduction, GR-5064, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. kaspar.soerensen@rh.regionh.dk
Mouritsen
Annette
A
Mogensen
Signe Sloth
SS
Aksglaede
Lise
L
Juul
Anders
A
D015502:Absorptiometry, Photon; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007118:Immunoassay; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood*; D008137:Longitudinal Studies; D011629:Puberty, Precocious / Q000378:metabolism*; D012307:Risk Factors; D018709:Statistics, Nonparametric
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids