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Metabolic changes in children with idiopathic central precocious puberty after gonadotrophin-releasing hormone
Bo Zhou1, Xia Qu1, Jianhong Wang1
1Child Healthcare Center, Capital Center for Children's Health, Capital Medical University, Beijing, China.
Insights
Gonadotrophin-releasing hormone agonist (GnRHa) therapy did not significantly alter BMI or lipid profiles in children with idiopathic central precocious puberty (ICPP). However, high-density lipoprotein levels showed a statistically significant increase following GnRHa treatment.
Area of Science:
- Pediatric Endocrinology
- Metabolic Health
- Clinical Trial Synthesis
Background:
- Idiopathic central precocious puberty (ICPP) is a condition characterized by early onset of puberty.
- GnRH agonist (GnRHa) therapy is a standard treatment for ICPP, but its long-term metabolic effects require thorough evaluation.
- Understanding the impact of GnRHa on metabolic parameters is crucial for comprehensive patient management.
Purpose of the Study:
- To systematically evaluate the metabolic effects of GnRHa therapy in children diagnosed with ICPP.
- To synthesize evidence from multiple clinical trials to provide a robust assessment of GnRHa's impact on BMI and lipid profiles.
- To investigate potential correlations between treatment and metabolic changes, considering factors like obesity.
Main Methods:
- A meta-analysis was performed, synthesizing data from 19 clinical trials involving 1,553 children with ICPP.
- Independent literature searches, trial selection, data extraction, and quality assessments were conducted.
- Statistical analyses used STATA software, with effect sizes expressed as weighted mean differences (WMD) and 95% confidence intervals (CI).
Main Results:
- GnRHa therapy showed no significant effect on body mass index standard deviation score (BMISDS) (WMD: -0.08; 95% CI: -0.22-0.06; p=0.269).
- No significant changes were observed in total cholesterol, triglycerides, or low-density lipoprotein levels.
- A statistically significant increase in high-density lipoprotein was noted (WMD: 7.07 mg/dL; 95% CI: 3.00-11.14; p=0.001).
Conclusions:
- GnRHa treatment in children with ICPP does not appear to adversely affect BMI or major lipid metabolism parameters.
- The observed increase in high-density lipoprotein warrants further investigation but suggests a potentially favorable lipid profile modification.
- Findings hold true irrespective of the child's obesity status at the initiation of therapy.
Background:
We aimed to assess the effects of gonadotrophin-releasing hormone agonist (GnRHa) therapy on metabolic changes by synthesizing results from clinical trials involving children with idiopathic central precocious puberty (ICPP).
Methods:
Literature search, trial selection, data extraction and quality assessment were completed independently by two investigators. STATA software (version 14.1) was used for data analyses. Effect-size estimates are expressed as weighted mean difference (WMD) with 95% confidence interval (CI).
Results:
This meta-analysis was conducted based on 19 clinical trials and 1,553 ICPP children. Overall analyses showed that for body mass index standard deviation score (BMISDS), no significance was noted after administering GnRHa to children with ICPP (WMD: -0.08; 95% CI: -0.22-0.06; p = 0.269). Similarly, no significance was noted for total cholesterol (WMD: 1.94 mg/dl; 95% CI: -10.29-14.17; p = 0.756), triglyceride (WMD: -5.31 mg/dl; 95% CI: -26.92-16.29; p = 0.630) and low-density lipoprotein (WMD: -9.63 mg/dl; 95% CI: -40.09-20.83; p = 0.535). By contrast, a statistically higher high-density lipoprotein of 7.07 mg/dl after administering GnRHa to children with ICPP (95% CI: 3.00-11.14; p = 0.001). Subgroup and meta-regression analyses revealed that initial body weight, sample size, and age were significant sources of between-trial heterogeneity. There was a low probability of publication bias for above comparison, as indicated by Egger's tests.
Conclusions:
Our meta-analytical findings indicate that GnRHa treatment did not appear to increase BMI and lipid metabolism levels in children with ICPP, irrespective of obesity status at the time of initiation therapy.
Systematic Review Registration:
PROSPERO (CRD42023410554).
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