Thyroid function in girls with central precocious puberty

Abstract

Purpose Obesity is a well-known risk factor for central precocious puberty (CPP). Recently, elevated thyroid stimulating hormone (TSH) was reported in obese youth. However, few data regarding the relationship between CPP and TSH are available. The aim of this study was to evaluate thyroid function in girls with CPP and the relationship between CPP and serum TSH concentration. Methods This was a retrospective cross-sectional study. A total of 1,247 girls aged between 6.0 and 8.9 years who had undergone a gonadotropin-releasing hormone (GnRH) stimulation test to determine the presence of puberty were studied. Subjects were classified into CPP (n=554) and non-CPP (n=693) groups according to the results of the GnRH stimulation test. Characteristics and laboratory data of the CPP and non-CPP groups were compared and correlations between those characteristics and laboratory data and TSH concentration were evaluated. Serum TSH concentration in the CPP group was higher than that of the non-CPP group (3.19±1.55 mIU/L vs. 2.58±1.34 mIU/L, P <0.001). Results Serum free thyroxine (fT4) concentration in the CPP group was notably lower than that of the non-CPP group (1.38±0.14 ng/dL vs. 1.44±0.18 ng/dL, P <0.001). Across all subjects, 149 girls (11.9%) had hyperthyrotropinemia. The prevalence of hyperthyrotropinemia was higher in the CPP group compared to the non-CPP group (15.7% vs. 8.9%, P <0.001). TSH concentrations were positively correlated with age, height, weight, BMI, bone age, bone age advance, insulin-like growth factor 1 (IGF-1), IGF-1 standard deviation score, basal luteinizing hormone (LH), peak LH and basal follicle-stimulation hormone. TSH concentrations were negatively correlated with fT4. Multiple linear regression analysis showed that age ( β =0.548, P <0.001) and peak LH ( β =0.019, P =0.008) were independently associated with serum TSH concentration. Conclusions Hyperthyrotropinemia in girls with CPP tends to be associated with pubertal LH elevation. In conclusion, pubertal onset may be associated with thyroid function.

Serum Levels of Thyroid Stimulating Hormone and Luteinizing Hormone Are Decreased in Girls with Central Precocious Puberty after 12-Month GnRH Agonist Treatment

“…In addition, age and peak LH level were independently predictive of serum TSH concentration. We concluded that the onset of puberty was related with TSH elevation (Jung et al 2019).…”

“…To further investigate our previous findings (Jung et al 2019) and to determine the causal relationship between TSH and LH levels, we collected the data from 221 girls with precocious puberty and compared their TSH and LH levels before and after GnRH agonist treatment. Our data revealed that patients' peak LH levels and TSH levels were decreased after GnRH agonist treatment.…”

“…In our previous study, the CPP group had higher TSH and lower free thyroxine (fT4) levels than the participants without CPP, and hyperthyrotropinemia was related to age and LH level (Jung et al 2019). In older patients and those with higher peak LH levels, TSH levels were higher.…”

Thyroid Function Changes and Pubertal Progress in Females: A Longitudinal Study in Iodine-Sufficient Areas of East China

“…A pre-pubertal surge in TSH, followed by a transient rise in circulating T3 and T4, along with an enhanced peripheral conversion of T4 to T3, was reported in 9-year-old children, while a decreasing or constant TSH, alongside a progressive decline in T3 and T4 was reported at increasing maturation of puberty (30,31). In addition, the fluctuations in THs might represent the elevated activities in the thyroid gland preparing for pubertal development, or an outcome of fluctuations in other factors including growth hormone (GH), insulin-like growth factor 1 (IGF-1), and basal luteinizing hormone (LH) (11,(32)(33)(34). a Puberty pattern: "B P F P +B P F L ", pre-pubertal at both baseline and follow-up & pre-pubertal at baseline and late-pubertal at follow-up, respectively; "B P F T , pre-pubertal at baseline and post-pubertal at follow-up, respectively", "B L F L , late-pubertal at both baseline and follow-up", "B L F T , late-pubertal at baseline and post-pubertal at follow-up, respectively" and "B T F T , postpubertal at both baseline and follow-up".…”

“…A pre-pubertal surge in TSH, followed by a transient rise in circulating T3 and T4, along with an enhanced peripheral conversion of T4 to T3, was reported in 9-year-old children, while a decreasing or constant TSH, alongside a progressive decline in T3 and T4 was reported at increasing maturation of puberty ( 30 , 31 ). In addition, the fluctuations in THs might represent the elevated activities in the thyroid gland preparing for pubertal development, or an outcome of fluctuations in other factors including growth hormone (GH), insulin-like growth factor 1 (IGF-1), and basal luteinizing hormone (LH) ( 11 , 32 – 34 ).…”