trelstar and Obesity

Topics: Adolescent; Body Mass Index; Child; Epilepsy; Female; Follicle Stimulating Hormone; Follow-Up Studies; Gonadal Steroid Hormones; Gonadotropin-Releasing Hormone; Humans; Luteinizing Hormone; Male; Obesity; Ovary; Puberty, Precocious; Testis; Triptorelin Pamoate

To investigate longitudinally body mass index (BMI) evolution and obesity prevalence in a large and very homogeneous study population consisting only of girls with non-organic central precocious puberty (CPP) who were treated with gonadotropin-releasing hormone agonists (GnRHa) for at least two years.. The 101 girls with idiopathic CPP who were selected for this study fulfilled the following inclusion criteria: (a) suppression of gonadotropin and gonadal sex steroid secretion during the overall GnRHa treatment period; (b) adequate compliance with the therapy regimen. All the girls were treated for 44+/-14 months and were followed-up for 15.7+/-7.8 months after therapy withdrawal.. At the start of therapy, 23.8% of the girls had a BMI exceeding 2 standard deviation scores (SDS) and were therefore classified as obese; both average BMI-SDS and obesity prevalence significantly decreased during the treatment period (chi(2)=16.6, P<0.0005) and only 4% of the patients, all with pre-existing obesity, were still obese at the end of therapy; during the therapy period, BMI-SDS increased in none of the patients. Both average BMI-SDS and obesity prevalence (from 4 to 0%; chi(2)=4.0, P<0.05) further decreased during the period that followed therapy withdrawal.. (a) girls with idiopathic CPP are frequently obese at the onset of GnRHa therapy (23.8%), probably due to the hormonal changes which accompany the start of puberty; (b) their obesity is neither long-lasting nor related to GnRHa administration; (c) on the contrary, GnRHa therapy may have a favourable effect on BMI decrease, provided that treatment is performed for at least two years and is accompanied by a complete suppression of gonadotropin secretion; (d) this unexpected effect, which has never been reported hitherto, might represent a further indication for GnRHa administration in idiopathic CPP.

Topics: Antineoplastic Agents, Hormonal; Body Mass Index; Child; Female; Follow-Up Studies; Humans; Longitudinal Studies; Obesity; Prevalence; Prospective Studies; Puberty, Precocious; Triptorelin Pamoate

Concern has been raised that children with central precocious puberty (CPP) are prone to the development of obesity. Here we report longitudinal height, weight, and body mass index (BMI) data from 96 girls and 14 boys with CPP before, during, and after GnRH agonist (GnRHa) administration. Skinfold thickness (n = 46) and percent body fat by dual energy x-ray absorptiometry (n = 21) were determined in subsets for more accurate assessment of body composition and to validate the use of the BMI SD score as an index of body fatness in our subjects. Before the initiation of therapy (PRE), the girls with CPP had a mean BMI SD score for chronological age (CA) of 1.1+/-0.1 and for bone age (BA) of 0.1+/-0.1. By the end of the study, 12-24 months after the discontinuation of GnRHa, the mean BMI SD score was 0.9+/-0.1 for CA and 0.6+/-0.1 for BA. At the visit when GnRHa was discontinued, 41% and 22% of the girls had a BMI SD score for CA more than the 85th and 95th percentiles, respectively, indicating that obesity was present at a high rate among our subjects; the BMI SD score for CA at the PRE visit was its strongest predictor. Indeed, 86% of the girls with BMI SD score for CA above the 85th percentile when GnRHa was discontinued also had BMI SD score for CA above the 85th percentile at the PRE visit. The proportion of boys with elevated BMI SD score for CA was also high. Fifty-four percent and 31% of the SD scores were greater than the 85th and 95th percentiles after 36 months of GnRHa therapy; the BMI SD score for CA PRE had been above the 85th percentile in 71% of these overweight subjects. Obesity occurs at a high rate among children with CPP, but does not appear to be related to long term pituitary-gonadal suppression induced by GnRHa administration. Children with CPP should have a baseline BMI SD score calculated, and those at risk for obesity should be counseled appropriately.

Topics: Adolescent; Body Composition; Body Height; Body Mass Index; Child; Child, Preschool; Female; Gonadotropin-Releasing Hormone; Humans; Male; Obesity; Puberty, Precocious; Skinfold Thickness; Triptorelin Pamoate; Weight Gain

This study aims to evaluate the effects and pregnancy outcomes of gonadotropin-releasing hormone agonist (GnRH agonist) combined with aromatase inhibitor (AI) in preserving the fertility of obese women with grade 1 endometrial cancer (EC).. This study recruited obese EC patients who wished to preserve their fertility. The treatment regimen consisted of intramuscular GnRH agonist 3.75 mg every 4 weeks and oral AI 2.5 mg daily. The maintenance regimen was the same as the initial treatment regimen. Primary outcomes included response rate, time to complete response (CR), and time to recurrence; pregnancy outcomes included the time to pregnancy, pregnancy rate and live birth rate.. Six obese patients with EC were included in this study, with the age (mean±standard deviation [SD]) of 30.5±3.3 years and body mass index (mean±SD) of 35.0±1.4 kg/m². CR rate was 100%, and time to CR was 3-6 months. None of the patients had recurrence after a median follow-up of 4.0 years (range, 1.3-7.0 years). The most common side effects were menopause-like symptoms. Among these patients, no weight gain was observed during treatment. The pregnancy rate and live birth rate was 50.0% and 75.0%, respectively, with a median time to pregnancy of 2.4 years (range, 1.0-5.5 years).. The combination of GnRH agonist and AI demonstrated promising long-term effect in young obese EC patients who wished to preserve their fertility. No weight gain side effects were observed. Further studies with a larger sample size are needed to fully evaluate this novel treatment regimen.

Topics: Administration, Oral; Adult; Aromatase Inhibitors; Birth Rate; Endometrial Neoplasms; Female; Fertility Preservation; Gonadotropin-Releasing Hormone; Humans; Injections; Letrozole; Obesity; Pilot Projects; Pregnancy; Triptorelin Pamoate

In modern society, obesity has become a major health problem and has been associated with impaired fertility. The aim of this study is to assess the role of obesity in women undergoing controlled ovarian hyperstimulation (COH) stimulated either with GnRH agonists or with GnRH antagonists. Records of 463 women undergoing in vitro fertilization (IVF) treatment were reviewed. The influence of body mass index (BMI) on treatment outcome was examined, after accounting for differences in stimulation protocols. In the agonist group (286 patients), the total amount of gonadotropins used was significantly higher in patients with a BMI ≥ 25 kg/m², when compared to those with a normal BMI. The same result was found in the antagonist group (177 patients). No significant differences were found in length of stimulation, number of oocytes retrieved or number of embryos transferred. In both the antagonist and the agonist group, the number of clinical pregnancies was found to be higher in patients with normal BMI, suggesting that obesity could impair the ovarian response to exogenous gonadotropins. Considering the results obtained and the many theoretical advantages of GnRH antagonists, ovarian stimulation with GnRH antagonists is an efficient treatment for both women with normal and high BMI.

Topics: Adult; Body Mass Index; Dose-Response Relationship, Drug; Embryo Transfer; Female; Fertilization in Vitro; Follicle Stimulating Hormone, Human; Gonadotropin-Releasing Hormone; Gonadotropins; Hormone Antagonists; Humans; Infertility, Female; Obesity; Ovary; Overweight; Ovulation Induction; Pregnancy; Prospective Studies; Recombinant Proteins; Triptorelin Pamoate; Ultrasonography

Topics: Antineoplastic Agents; Antineoplastic Agents, Hormonal; Biomarkers; Chorionic Gonadotropin; Endocrinology; Estrogens; Female; Fertility Agents, Female; Humans; Middle Aged; Obesity; Ovarian Neoplasms; Pregnancy; Pregnancy, Ectopic; Primary Ovarian Insufficiency; Reproductive Medicine; Triptorelin Pamoate; Weight Reduction Programs

To explore the effects of overweight and obesity on the outcomes of in vitro fertilisation (IVF) in Chinese infertile patients.. A retrospective cohort study was carried out in 2222 normal weight (18.5 or= 30) women who underwent their first IVF cycles between 2002 and 2008. Cycle characteristics and IVF outcomes were analysed.. Obese women required significantly higher dose of rFSH (3272 IU vs. 2587 IU, p < 0.001) and days of stimulation (11.89 +/- 4.57 vs. 10.42 +/- 2.03, p < 0.001), but exhibited less oocytes retrieved and significantly lower fertilisation rate (54.1% vs. 61.1%, p < 0.001) than normal weight women. Compared with normal weight women, overweight women displayed significantly less oocytes retrieved (12.98 +/- 6.91 vs. 14.49 +/- 7.96, p < 0.001), lower fertilisation rate (60.8 +/- 23.3 vs. 61.1 +/- 23.0, p < 0.001), less cleavaged embryos (7.55 +/- 4.86 vs. 8.67 +/- 5.90, p < 0.001), less high-grade embryos (4.65 +/- 3.96 vs. 5.59 +/- 4.81, p < 0.001) and cryopreserved embryos (4.44 +/- 4.55 vs. 5.49 +/- 5.55, p < 0.001). All parameters of pregnancy outcomes, including pregnancy rate, miscarriage rate and live birth rate, were comparable among three groups.. Overweight and obesity are related with impared ovarian response, and negatively affect the outcomes of IVF.

Topics: Adult; Body Mass Index; China; Cohort Studies; Cryopreservation; Female; Fertilization in Vitro; Follicle Stimulating Hormone; Humans; Infertility; Obesity; Oocytes; Overweight; Ovulation Induction; Pregnancy; Pregnancy Outcome; Recombinant Proteins; Retrospective Studies; Sperm Injections, Intracytoplasmic; Tissue and Organ Harvesting; Treatment Outcome; Triptorelin Pamoate

Was to evaluate the body mass index (BMI) changes in girls with central precocious puberty (CPP) treated with a GnRH analog (GnRHa) and to analyse the factors affecting BMI.. 43 girls with puberty onset aged (mean, +/-SD) 6.1+/-1.9, treated with 3.75 mg Decapeptyl Depot i.m. every 28 days. The treatment was initiated at the age of 7.5+/-2.1 year and continued for 3.3+/-2.2 year until the age of 11.4+/-0.9 year. The height, weight and BMI data were evaluated before, during and after GnRH agonist administration. Using recommended Polish BMI cut-off values we defined overweight in children of 90th and 97th centiles and obesity above 97th centile.. There was no statistical difference between BMI SD score before initiation of therapy and at the end of therapy (p=0.49). 9.8% of the cohort were overweight and 22.0% were obese before treatment. At the end of the therapy 18.6% children were overweight and 14.0% obese. These differences were not statistically significant. There was no significant correlation between overweight and obesity at the end of treatment and the duration of the therapy (r=-0.17) and with the duration of CPP before introduction of GnRH therapy (r= -0.11).. 1.Overweight and obesity are not related to long term pituitary-gonadal suppression due to GnRH analogue treatment. 2. The rate of overweight and obesity among children with CPP is higher than in the general population. Thus detailed evaluation of metabolic status of overweight children with CPP should be performed in order to prevent complications of the metabolic syndrome.

Topics: Body Height; Body Mass Index; Child; Cohort Studies; Comorbidity; Female; Humans; Obesity; Overweight; Prevalence; Puberty, Precocious; Triptorelin Pamoate

To evaluate serum leptin concentrations in hirsute women.. Controlled clinical study.. Tertiary institutional hospital.. Thirty-three hirsute women and 11 healthy female controls.. Serum samples were obtained at baseline and on day 1 (gonadal stimulation) and day 21 (gonadal suppression) after the IM injection of a single 3.75-mg dose of triptorelin.. Leptin, T, sex hormone-binding globulin (SHBG), insulin, and glucose levels and free androgen index.. Leptin levels were increased in hirsute women in comparison with control subjects at baseline and on day 1. Leptin levels increased on day 1 compared with baseline and then decreased to baseline by day 21. Leptin levels correlated with body mass index (r = 0.76), SHBG levels (r = -0.52), free androgen index (r = 0.38), insulin levels (r = 0.46), and the glucose/insulin ratio (r = -0.38). When the effect of obesity on these results was removed by analysis of covariance and partial correlation analysis, leptin levels remained elevated only on day 1 and the only correlations that remained significant were those of leptin with insulin (r = 0.24) and the glucose/insulin ratio (r = -0.24).. The increased leptin levels found in hirsute women are related mainly to obesity and also to insulin resistance. Leptin levels increased during gonadal stimulation and returned to baseline during gonadal suppression, suggesting that leptin also is influenced by the gonadal axis.

Topics: Adrenocorticotropic Hormone; Adult; Body Mass Index; Estradiol; Female; Follicle Stimulating Hormone; Hirsutism; Humans; Leptin; Luteinizing Hormone; Obesity; Proteins; Reference Values; Sex Hormone-Binding Globulin; Testosterone; Triptorelin Pamoate

Description of the recessive, homozygote obese Zucker rat (fafa) includes disorders of growth and reproduction. The aim of this study was to compare responsiveness of adenohypophyseal cells, obtained from male fafa rats and from their lean siblings, to growth hormone-releasing factor (GRF) and to luteinizing hormone-releasing hormone (LHRH). Pituitary cells were cultured for 4 days and were then challenged with either GRF-29 (the NH2-terminal 29 amino acid GRF peptide that expresses full biological activity of its parent 44 amino acid molecule) or [D-Trp6]LHRH (LHRH-A, an LHRH agonist). Medium was assayed for growth hormone (GH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) by radioimmunoassay. Dose-response curves were compared using the computer program ALLFIT. The median effective GRF-29 concentration (EC50) computed for hypophyseal cells cultured from lean animals (0.30 +/- 0.01 fM; means +/- SE of 4 experiments) was less (P less than 0.01) than that calculated for cells obtained from fafa rats (15.8 +/- 6.7 fM). In contrast, cells derived from lean littermates required a larger (EC50) concentration of LHRH-A than did gonadotrophs cultured from obese rats [58.2 +/- 1.2 vs. 10.7 +/- 1.2 pM (P less than 0.01) and 59.4 +/- 10.4 vs. 15.7 +/- 7.6 pM (P less than 0.05)] to secrete LH and FSH, respectively. Our data describe an attenuated pituitary response to GRF-29 and an enhanced response to LHRH-A in the fafa.

Topics: Animals; Dose-Response Relationship, Drug; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Growth Hormone; Growth Hormone-Releasing Hormone; Luteinizing Hormone; Male; Obesity; Peptide Fragments; Phenotype; Pituitary Gland, Anterior; Rats; Rats, Zucker; Sermorelin; Statistics as Topic; Triptorelin Pamoate