ESPE Abstracts

Objective: To investigate the role of serum anti-mullerian hormone (AMH) and inhibin-B (INHB) in central precocious puberty precocious puberty (CPP) and early and fast puberty (EFP).

Methods: A total of 423 girls with CPP, EFP, premature thelarche (PT) and undeveloped healthy who were treated in our Hospital from October 2020 to December 2022 were collected. General data, sex hormones, AMH, INHB levels and gonad ultrasound were collected. The data of each group were compared, and the diagnostic value of AMH and INHB in predicting CPP and their early warning value in EFP were judged by receiver operating characteristic curve, and the correlation of each index was analyzed by Spearman correlation analysis. Girls diagnosed with CPP or EFP at the same time were selected to receive GnRHa treatment. AMH, INHB, sex hormone detection, uterine volume (UV) and mean ovarian volume (M-OV) were evaluated at the 6th and 12th month of treatment. The changes of each index before and after treatment were compared to explore whether AMH and INHB can be used to evaluate the therapeutic effect of GnRHa.

Results: The serum levels of AMH and INHB in the CPP group were higher than the PT group, while the INHB in the EFP group were higher than the PT group. For CPP diagnosis, INHB demonstrated superior diagnostic accuracy (AUC=0.815, sensitivity=83%, specificity=62.7%) compared to AMH (AUC=0.576). Additionally, AMH correlated negatively with peak levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). In early warning of EFP, both INHB (AUC=0.896, sensitivity=90.7%, specificity=77.6%) and UV(AUC=0.944, sensitivity=90.7%, specificity=77.6%) performed well, but their combination provided the highest accuracy (AUC=0.964, sensitivity=93.8%, specificity=87.4%). In EFP, INHB was positively correlated with UV, LH basal value, FSH basal value, and LH basal value/FSH basal value. After 6 and 12 months of GnRHa treatment, INHB decreased significantly in both CPP and EFP, and the decrease rate of INHB was positively correlated with the decrease rate of LHp and FSHp. The change of AMH level before and after treatment was not statistically significant.

Conclusion: 1. This study verified the diagnostic value of INHB in CPP girls. 2. This study suggests that AMH level can be used as a potential indicator to distinguish central precocious puberty from early breast development. 3. INHB level combined with UV detection is significant for early warning of EFP girls in clinic. 4. INHB has important reference value in evaluating the efficacy of GnRHa in CPP and EFP girls.