ESPE2023 Poster Category 2 Sex Differentiation, Gonads and Gynaecology, and Sex Endocrinology (27 abstracts)
1UPV-EHU Pediatric Departament, Vitoria, Spain. 2HU Araba - Pediatric, Vitoria, Spain. 3Bioaraba, Vitoria, Spain
During the pandemic, an increase in the cases of premature thelarche consultations was observed. Our group published a series in 2021 of 75 cases. This effect could have been caused by an increase in body fat mass in girls, suggesting a “trigger effect” in the activation of the gonadal axis, causing an increase in the number of cases of early puberty (SEEP Oviedo 2022). AMH has been correlated as a predictor of the moment of menarche (doi: 10.1515/jpem-2014-0521)
Objectives: To assess the existing correlation between AMH values in premature thelarche and the actual evolution to precocious puberty.
Patients and Methods: 75 cases of girls assessed for premature thelarche in 2019 and 97 cases in 2020 were analyzed. variables were analyzed for each patient, such as somatometry, hormones, echo, AMH, treatment... and follow-up was performed. Clinical reassessment in 2022. SPSS studies 19.0 non-parametric studies for n<30
Results: In 2019, 75 first visits by girls were due to premature thelarche; 55% 41/75 presented lipomastia and normal puberty (PN), 40% (30/75) were diagnosed with early puberty (PT), and 4/75 (5%) had evidence of central precocious puberty (PPC).. On the contrary, in 2020, of the 97 consultations, 62% 60/97 presented lipomastia and PN, 32% (31/97) were diagnosed with TP, and PPC was found in 6/97 (5%). Total Central precocious puberty 10/172 cases, advanced thelarche 61/172 and 101/172 lipomastia -others. AMH data 21 patients (13+8) The mean AMH levels (n:21) of the PPC group (6/21) were significantly lower than those of the PT group (10/21) (18.7±9.8 pmol/L and 42.42±12.7 pmol /L, respectively, P=0.022). The PT and PN (5/19) group was similar
Conclusion: Although the n studied is low (we plan to increase the n in the future), these results suggest that AMH levels decrease when the hypothalamic-pituitary-ovarian axis is activated. We think that AMH could/can be a marker to distinguish between CPP and PT and could be considered for inclusion in clinical practice.