title: Insulin sensitivity and lipid profiles in girls with central precocious puberty before and during gonadal suppression.
abstract: 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.
authors.affiliation: Department of Growth and Reproduction, GR-5064, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. kaspar.soerensen@rh.regionh.dk
authors.forename: Kaspar
authors.initials: K
authors.lastname: Sørensen
authors.forename: Annette
authors.initials: A
authors.lastname: Mouritsen
authors.forename: Signe Sloth
authors.initials: SS
authors.lastname: Mogensen
authors.forename: Lise
authors.initials: L
authors.lastname: Aksglaede
authors.forename: Anders
authors.initials: A
authors.lastname: Juul
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008055:Lipids