The Effect of GnRHa Treatment on Body Mass Index in Central Precocious Puberty: A Systematic Review and Meta-Analysis

Abstract

<b><i>Background:</i></b> Recently, numerous studies have addressed the long-term effects of treatment with gonadotropin-releasing hormone analog (GnRHa) in patients with central precocious puberty (CPP). However, the effects of GnRHa treatment on body mass index (BMI) in patients with CPP remain controversial. <b><i>Objective:</i></b> This systematic review and meta-analysis aimed to evaluate the association between GnRHa treatment and BMI in patients with CPP. <b><i>Methods:</i></b> A systematic search of databases, PubMed, EMBASE, and Web of Science published before August 2021 identified relevant studies. The overall effect analysis was performed using STATA version statistical software 15.0. <b><i>Results:</i></b> The study included a total of 28 studies. At the end of GnRHa treatment, the BMI-standard deviation score (BMI-SDS) was greater than baseline BMI-SDS (weighted mean difference (WMD) = 0.14, 95% CI: 0.04–0.23; <i>p</i> = 0.004), especially in girls with CPP (WMD = 0.15, 95% CI: 0.05–0.25; <i>p</i> = 0.005) and in patients with normal weight (WMD = 0.34, 95% CI: 0.19–0.48, <i>p</i> &lt; 0.001). After reaching adult height, BMI-SDS returned to baseline, suggesting that the effect of GnRHa treatment on BMI would disappear as the child grew (WMD = −0.03, 95% CI: −0.39 to 0.32; <i>p</i> = 0.815). <b><i>Conclusion:</i></b> For patients with CPP, while treatment with GnRHa may increase the BMI in the short term after treatment, the BMI is likely to return to normal when the patients reach adult height.