1.Height Velocity and Body Mass Index Changes During Gonadotropin-Releasing Hormone Agonist Therapy in Children with Central Precocious Puberty (CPP)
Alexis Lordudass ; Nuratikah Mohd Ghazali ; Jay Yin Lim ; Mazidah Noordin ; Noor Shafina Mohd Nor
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):136-
Introduction:
Precocious puberty is increasingly recognized in children.
Effect of gonadotropin-releasing hormone agonist (GnRHa)
on height velocity (HV) and body mass index (BMI) during
treatment of Central Precocious Puberty (CPP) is not welldocumented.
Methodology:
Records of all patients treated with GnRH for CPP who
attended the paediatric endocrine clinic over a 5-year
period (2021–2025) [N1.1] were reviewed retrospectively
for HV and BMI changes for 3 consecutive years. Basal
luteinizing hormone levels ≥0.3 IU/L or stimulated levels
≥5 IU/L are considered diagnostic of CPP.
Results:
Twenty patients were reviewed and median age at the start
of study was 7.8 years (4.3–10.3). Majority were female (n =
18, 90%) with median Tanner Stage 3 and of Malay origin
(n = 18, 90%[N2.1]). Median chronological age was 7.8 years
(4.3–10.3) with bone age 10.3 years (5.8–13.4).
Causes of CPP were idiopathic (n = 16, 80%), CNS lesion
(n = 2, 10%) and poorly controlled congenital adrenal
hyperplasia (n = 2, 10%). Nine (82%) of the 11 patients who
had MRI brain done had normal findings. After 1 year of treatment, the median HV SDS was −0.83
(range −2.45 to 2.42), and BMI SDS was 0.45 (−1.94 to 2.15).
After 2 years (n = 12), HV SDS declined to −1.3 (−3.44 to
0.69), with BMI SDS of 0.13 (−1.16 to 1.79). After 3 years (n
= 9), HV SDS declined further to −1.51 (−3.52 to 3.13), and
BMI SDS was 0.16 (−0.12 to 1.25).
After 1 year of treatment, 20% (n = 4) of patients were
overweight and 10% (n = 2) were obese. By 3 years, 22% (n
= 2) remained overweight, and none were obese.
Conclusion
Premature growth plate senescence induced by prior
estrogen exposure may lead to HV decline. Although
obesity is a risk factor for the onset of CPP, whether GnRHa
treatment directly increases BMI remains controversial
as our cohort’s BMI change reveals otherwise.
Child
;
Body Mass Index
;
Puberty, Precocious
;
Hormones


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