**3. Results**

306 Sex Steroids

1999, Chiumello et al., 2000, van der Sluis et al., 2002, Paterson et al., 2004). However, most of these reports studied populations in Western countries, and almost none investigated Asian children (Wacharsindhu et al., 2006). Furthermore, in these studies, GnRHa was administered at higher doses (Boot et al., 1998, Chiumello et al., 2000, van der Sluis et al., 2002) than are used in the standard gonadotropin-suppressive therapy protocol that is currently in operation in Japan. With some exceptions, all these reports showed that obesity is aggravated during GnRHa therapy (Wacharsindhu et al., 2006, Boot et al., 1998, Chiumello et al., 2000, van der Sluis et al., 2002, Paterson et al., 2004, Oosdijk et al., 1996, http://www.iotf.org/documents/iotfsocplan251006.pdf). Therefore, we assessed the effects of the standard gonadotropin-suppressive therapy protocol that is currently used in Japan

The aims of the present study were to prospectively evaluate whether obesity occurs at a high frequency among Japanese children with CPP and to longitudinally evaluate the body

Eighteen patients participated in the study. At diagnosis, all of the patients had a history of increased growth velocity, breast development of Tanner stage 2 or more, and a bone age that was more than 1 yr above their chronological age. Ten girls had idiopathic central precocious puberty (ICPP), and 8 girls had idiopathic central early puberty (ICEP). The diagnosis of ICPP was made based upon the onset of breast development before the age of 7 yr and 6 mo, the generation of pubic hair before the age of 9 yr, or the onset of menses before the age of 10 yr and 6 mo, according to the diagnostic criteria currently used in Japan. ICEP was defined as the appearance of pubertal signs between 8 -10 yr of age. Furthermore, neither set of patients showed any evidence of hypothalamo-pituitary lesions on magnetic resonance imaging or

The median age at the start of treatment was 8.3 yr (range: 6 to 11). All patients received leuprolide acetate (LUPRON DEPOT, Takeda, Osaka, Japan) at an initial dose of 30 g/kg, which was administered subcutaneously every 4 weeks according to the standard

Standard anthropometric measurements were taken at the baseline and during the 2-year GnRHa treatment period. BMI was calculated as weight (kg)/height (m2), compared with age- and sex-matched reference values, and expressed as a standard deviation score (SDS) according to the method of Inokuchi (Inokuchi, 2009). The percentage of overweight (POW) was calculated as 100 x (the measured weight – normal weight)/normal weight (%). Normal weight data were derived from the 1990 Ministry of Health and Welfare data (Yamazaki et al., 1994). A POW of ≥ 20% was considered to indicate obesity (Asayama et al., 2003). Pubertal development was determined according to the method of Tanner (Tanner &

Pituitary-gonadal axis function was considered to be adequately suppressed during treatment if the concentrations of LH and E2 were maintained within the prepubertal normal ranges of our laboratory; i.e., if a) the basal serum LH level was below 0.5 mIU/ml and b) the basal serum E2 level was below 10 pg/ml. In the patients that demonstrated

on body composition in order to review the optimal dose of GnRHa.

**2. Subjects and methods** 

**2.1 Patients** 

**2.2 Methods** 

Whitehouse, 1976).

composition of Japanese children with CPP before and during GnRHa therapy.

additional conditions that might have affected their body mass index (BMI).

gonadotropin-suppressive therapy currently used in Japan.
