ESPE Abstracts

Introduction and Purpose: The appearance of secondary sex characteristics 2-2.5 standard deviation score (SDS) earlier than the expected age is defined as precocious puberty. Childhood obesity has emerged as an important public health problem in recent years. GnRH stimulation test is considered the gold standard in the diagnosis of precocious puberty. Our study aims to determine possible differences in responses according to body mass index in female patients who underwent GnRH stimulation test with the preliminary diagnosis of precocious puberty.

Materials and Methods: In this retrospective study, 241 female patients aged 6-9.5 years who applied to tertiary Pediatric Endocrinology clinic between September 2022 and December 2023 and underwent GnRH stimulation test with the preliminary diagnosis of precocious puberty were included. Patients were grouped according to their BMI SDS values as normal weight (BMI SDS between -1.5 and +1.5), overweight (BMI SDS between +1.5 and +2) and obese (BMI SDS > +2). Detailed anamnesis of the patients was taken and their demographic data, anthropometric measurements, laboratory results and radiological imaging were evaluated.

Results: Of the 241 female patients included in the study, 147 (60.99%) were normal weight, 46 (19.08%) were overweight, and 48 (19.91%) were obese. The mean calendar age of all cases was 7.8 ± 0.66 years, the mean bone age was 9.4 ± 1.2 years, and the mean height age was 8.7 ± 1.28 years. While there was no difference between basal LH and E2 levels, a difference was detected between basal FSH levels (P <0.05). A difference was detected between peak LH and peak FSH responses (P <0.05). GnRH analogue treatment was started in 37.3% of the cases, and there was a difference between the groups in terms of the frequency of treatment initiation (P <0.05). In our study, the test results of patients who underwent GnRH stimulation test with the preliminary diagnosis of precocious puberty were evaluated according to their BMI SDS, and a difference was detected between the groups in peak LH and peak FSH responses. The low peak LH responses in overweight and obese patients as a result of the GnRH stimulation test performed when basal LH levels are not sufficient to make a diagnosis indicate that it may be more appropriate to evaluate the results of the GnRH stimulation test, which is considered the gold standard test in terms of pre-puberty, together with other test results in these patients.