Basal Serum Neurokinin B Levels in Differentiating Idiopathic Central Precocious Puberty from Premature Thelarche

Abstract

Objective:To find out the diagnostic role of kisspeptin and neurokinin B in idiopathic central precocious puberty (ICPP) and premature thelarche (PT).Methods:The girls who presented with early breast development before the age of 8 years were evaluated. Patients with intracranial pathologies were excluded. Basal and stimulated follicle-stimulating hormone/luteinizing hormone (LH) levels and basal neurokinin B/kisspeptin levels were measured. Patients who had peak value of LH >5 mIU/mL and a bone age (BA)/chronological age (CA) ratio >1.1 were diagnosed as central precocious puberty (CPP), while cases who did not meet these criteria were diagnosed as PT. Healthy age-matched prepubertal girls were included as the control group.Results:The study group contained 25 girls with ICPP (7±0.8 years), 35 girls with PT (6.8±0.7 years), and 30 controls (6.7±0.7 years). Basal serum kisspeptin and neurokinin B levels were 2.36±0.47 ng/mL and 2.61±0.32 ng/mL, respectively in the ICPP group, 2.23±0.43 ng/mL and 2.24±0.23 ng/mL, respectively in the PT group, and 1.92±0.33 ng/mL and 2.03±0.24 ng/mL, respectively in the controls. Both kisspeptin and neurokinin B levels were higher in the ICPP and PT groups compared to controls (p<0.05). Moreover, basal neurokinin B level was different between ICPP and PT groups (p<0.01). A serum neurokinin B level of 2.42 ng/mL provided the most appropriate level to differentiate ICPP from PT, with a sensitivity of 84% and specificity of 77.1%.Conclusion:Differentiation of CPP from PT is sometime difficult, and there is a need for a simple method for the differential diagnosis. Our results suggest that basal serum neurokinin B level can be used as an adjunctive parameter to differentiate ICCP from PT.

The role of kisspeptin and MKRN3 in the diagnosis of central precocious puberty in girls

“…Although the method is highly sensitive, its specificity is low (94.1% sensitivity and 60.7% specificity), which limits its use as a single diagnostic tool until further data can be obtained from conducting larger studies. Perhaps an improvement to diagnosis can be achieved by incorporating measurements for another metabolite, such as serum levels of neurokinin B ( 32 ).…”

Kisspeptin Levels in Girls with Precocious Puberty: A Systematic Review and Meta-Analysis

“…Using a systematic review and meta-analysis, we compared the KP levels between 316 girls with CPP and 251 controls from 11 studies (Table 1) [20,[34][35][36][37][38][39][40][41][42][43]. In all studies, the values of KP concentration were higher in CPP girls than in controls (SMD = 1.53; CI 95% = 0.56-2.51), except in 1 study [42] which found no difference in KP levels.…”

“…Studies showed poor descriptions of the sample collection and pre-analytical procedures. The description of the healthy controls presented mixed results with 5 studies presenting limited descriptions [20,34,36,40,41]. However, the case group characteristics, description, and diagnostic criteria presented generally better descriptions.…”

“…A total of 11 studies [20,[34][35][36][37][38][39][40][41][42][43] were included, comprising 316 CPP patients and 251 controls. Figure 1 outlines study selection process in a PRISMA flowchart.…”

“…material, see www.karger.com/doi/10.1159/000515660). Four studies presented high risk of bias [19,36,40,41], and the remaining varied from mild [20] to low risk. Studies showed poor descriptions of the sample collection and pre-analytical procedures.…”