ESPE Abstracts

Gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard test for diagnosing central precocious puberty (CPP), which needs time and effort to perform. Recently, many studies confirmed that Insulin-like growth factor-1 (IGF-1) is involved in the initiation and progression of puberty. With this inspection, we assumed that the IGF-1 level might be correlated with the pubertal stage in central precocious puberty. This study aimed to investigate the value of IGF-1 levels in screening central precocious puberty. The medical records of 359 patients with a chief complaint of premature breast development who visited the pediatric endocrinology clinic in Myongji Hospital from January 2017 to October 2022 were reviewed. Two hundred thirty-three girls with central precocious puberty (CPP) and 126 girls with premature thelarche (PT) diagnosed were enrolled. Each subject had IGF-1 and GnRH stimulation test results. The anthropometric data between CPP and PT showed no statistical differences except for weight and the existence of lipomastia. The hormonal indicators including peak luteinizing hormone (peak LH), peak follicular stimulating hormone (peak FSH), and estradiol were statistically different between the two groups (P < 0.001). IGF-1 levels were significantly higher in the CPP group than in the PT group. The IGF-1 levels were positively correlated with peak LH, the diagnostic indicator of CPP. The area under the curve (AUC) of IGF-1 was 0.709. The sensitivity of IGF-1 in the diagnosis of CPP is 57.3% and the specificity is 77.6%. There was a strong positive correlation between the diagnosis of CPP and the IGF-1 levels (r= 0.709, p < 0.001; True positive [TP] =133, True negative [TN] = 99; False positive [FP] = 28, False negative [FN] = 99). Tanner staging is more developed in central precocious puberty than in early puberty (p < 0.001). Bone age alone is not suggestive of central precocious puberty compared with early puberty (P= 0.657). IGF-1 levels were correlated with the diagnostic indicator osis of central precocious puberty CPP. IGF-1 would be a useful tool for screening CPP.