ESPE2023 Poster Category 1 Pituitary, Neuroendocrinology and Puberty (73 abstracts)
Central Precocious Puberty in Boys; Diagnosis, Treatment and Follow-up: A Nation-Wide Study
Sevinc Odabasi Gunes 1 , Merve Sakar 2 , Nursel Muratoglu Sahin 2 , Gulay Karaguzel 3 , Emine Ayça Cimbek 3 , Feyza Darendeliler 4 , Ezgi Sarban 4 , Esra Doger 5 , Ganimet Onder 5 , Zeynep Siklar 6 , Gizem Senyazar 6 , Hasan Murat Aydin Aydin 7 , Behzat Ozkan 8 , Ozlem Sangun 9 , Mesut Parlak 10 , Onur Akin 1 , Kadriye Cansu Sahin 11 , Ihsan Esen 12 , Aylin Kilinc Ugurlu 13 , Gulcan Seymen 14 , Semih Bolu 15 , Elif Sobu 16 , Servan Ozalkak 17 , Emine Demet Akbas 18 , Gonul Buyukyilmaz 13 , Beray Selver Eklioglu 19 , Ahmet Ucar 20 , Pinar Kocaay 13 , Selma Tunc 21 , Serpil Bas 22 , Ismail Dundar 23 , Eda Celebi Bitkin 24 , Ayca Torel Ergur 25 , Dilek Bingol Aydin 26 , Birgul Kirel 27 , Aysun Ata 18 , Muge Atar 28 , Mehmet Isakoca 29 , Emel Hatun Aytac Kaplan 29 , Tugba Kontbay 28 , Derya Tepe 30 , Oya Ercan 26 , Mehmet Boyraz 13 , Nesibe Akyurek 31 , Edip Unal 32 , Nurhan Ozcan Murat 33 , Serkan Bilge Koca 34 , Zumrut Kocabey Sutcu 35 & Semra Çetinkaya 2
1UHS Gulhane Training and Research Hospital, Department of Pediatric Endocrinology, Ankara, Turkey. 2UHS Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey. 3Karadeniz Technical University, Faculty of Medicine, Department of Pediatric Endocrinology, Trabzon, Turkey. 4Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey. 5Gazi University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey. 6Ankara University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey. 7Ondokuz Mayis University, Faculty of Medicine, Department of Pediatric Encodrinology, Samsun, Turkey. 8UHS Dr. Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital Department of Pediatric E Endocrinology, Izmir, Turkey. 9Baskent University, Adana Dr. Turgut Noyan Application and Research Center, Department of Pediatric Endocrinology, Adana, Turkey. 10Akdeniz University, Faculty of Medicine, Department of Pediatric Endocrinology, Antalya, Turkey. 11Bursa Uludag University, Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey. 12Firat University, Faculty of Medicine, Department of Pediatric Endocrinology, Elazığ, Turkey. 13Ankara City Hospital, Pediatric Endocrinology Clinic, Ankara, Turkey. 14UHS Umraniye Training and Research Hospital, Clinic of Pediatric Endocrinology, Istanbul, Turkey. 15Adiyaman Training and Research Hospital, Department of Pediatric Endocrinology, Adiyaman, Turkey. 16Istanbul Kartal Dr. Lutfi Kirdar City Hospital, Department of Pediatric Endocrinology, Istanbul, Turkey. 17Diyarbakir Gazi Yasargil Training and Research Hospital, Department of Pediatric Endocrinology, Diyarbakir, Turkey. 18UHS Adana City Training and Research Hospital, Department of Pediatric Endocrinology, Adana, Turkey. 19Necmettin Erbakan University, Meram Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey. 20UHS Sisli Hamidiye Etfal Health Application and Research Center, Clinic of Pediatric Endocrinology, Istanbul, Turkey. 21Diyarbakır Child Diseases Hospital, Clinic of Pediatric Endocrinology, Diyarbakir, Turkey. 22Kahramanmaraş Necip Fazıl City Hospital, Department of Pediatric Endocrinology, Kahramanmaras, Turkey. 23Malatya Training and Research Hospital, Clinic of Pediatric Endocrinology, Malatya, Turkey. 24Van Yuzuncu Yıl University, Faculty of Medicine, Department of Pediatric Endocrinology, Van, Turkey. 25Ufuk University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey. 26Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey. 27Eskisehir Osmangazi Faculty of Medicine, Department of Pediatric Endocrinology, Eskisehir, Turkey. 28Sanliurfa Training and Research Hospital, Department of Pediatric Endocrinology, Sanliurfa, Turkey. 29Mersin City Training and Research Hospital, Department of Pediatric Endocrinology, Mersin, Turkey. 30Yildirim Beyazit University Yenimahalle Training and Research Hospital, Department of Pediatric Endocrinology, Ankara, Turkey. 31Baskent University Konya Application and Research Center, Department of Pediatric Endocrinology, Konya, Turkey. 32Dicle University, Faculty of Medicine, Department of Pediatric Endocrinology, Diyarbakir, Turkey. 33UHS Derince Training and Research Hospital, Department of Pediatric Endocrinology, Kocaeli, Turkey. 34Afyonkarahisar University of Health Sciences, Department of Pediatric Endocrinology, Afyonkarahisar, Turkey. 35Basaksehir Cam ve Sakura City Hospital, Department of Pediatric Endocrinology, Istanbul, Turkey
Objective: The aim of this study was to evaluate demographic characteristics; clinical, laboratory, imaging features; and response to treatment of boys who were followed up and treated with the diagnosis of central precocious puberty (CPP) in Turkiye.
Materials and Methods: The study was planned as a multicenter, retrospective study. Cases with a diagnosis of CPP, whose follow-up data were available were included. Patients with diagnosis of congenital adrenal hyperplasia (CAH), or with any other chronic systemic diseases were excluded.
Results: 297 cases were registered into the study and 266 cases were included. Mean age at diagnosis was 7.96±2.2 years and bone age was 9.53±2.53 years. 18.8% of the cases were obese, 30% was overweight and 3.7% had malnutrition. At admission, median Tanner stage was stage II, mean basal LH level was 1.33±1.59 mIU/ml, and total testosterone level was 5.78±71.82 ng/ml. The mean peak LH level of 201 subjects who underwent LH-RH stimulation test was 11.58±8.0 (5-74) mIU/ml. Peak LH/FSH ratio was lower in obese cases than in non-obese cases (P=0.005). Intracranial pathological findings were present in 37.6% of 247 patients who underwent cranial imaging. Duration of treatment was 32.17±23.53 months. Mean age at cessation of treatment was 10.55±2.55 years, and bone age was 12.78±0.99 years. 4.5% of the patients reached final height. It was determined that there was no change in the height-SDS, and there was an increase in weight-SDS and body mass index (BMI)-SDS of the patients during the treatment process (P<0.001). Total testosterone and DHEAS levels were higher in cases with intracranial pathology (P<0.05). Among the cases with and without intracranial pathology; height-SDS change throughout treatment and final height difference from target height were similar. Factors affecting the final height were height-SDS and predicted heightat the beginning of the treatment, paternal height-SDS and target height-SDS.
Conclusion: In this nation-wide study with a large number of male CPP patients, more than half of the cases were diagnosed as idiopathic CPP. The peak LH/FSH ratio found to be lower in obese children, and similar to the girls with CPP, there was an increase in weight-SDS and BMI-SDS of the boys during treatment. It was determined that the height SDS and predicted height at the beginning of the treatment, the father's height SDS and the target height SDS were the factors affecting the final height.
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