Insulin sensitivity and lipid profiles in girls with central precocious puberty before and during gonadal suppression

TY - JOUR

T1 - Insulin sensitivity and lipid profiles in girls with central precocious puberty before and during gonadal suppression

AU - Sørensen, Kaspar

AU - Mouritsen, Annette

AU - Mogensen, Signe Sloth

AU - Aksglaede, Lise

AU - Juul, Anders

PY - 2010/8/1

Y1 - 2010/8/1

N2 - Context: 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. Design and Setting: This was a combined cross-sectional and longitudinal study at a tertiary center of pediatric endocrinology. Patients and Intervention: 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 re-evaluated after 12 and 52 wk of treatment. Main Outcome Measures: 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.

AB - Context: 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. Design and Setting: This was a combined cross-sectional and longitudinal study at a tertiary center of pediatric endocrinology. Patients and Intervention: 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 re-evaluated after 12 and 52 wk of treatment. Main Outcome Measures: 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.

U2 - 10.1210/jc.2010-0731

DO - 10.1210/jc.2010-0731

M3 - Journal article

SN - 0021-972X

VL - 95

SP - 3736

EP - 3744

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

IS - 8

ER -