Diagnostic evaluation of central precocious puberty in girls

Yeh, Shu-Nin; Ting, Wei-Hsin; Huang, Chi‐Yu; Huang, Shih-Kang; Lee, Yi‐Chen; Chua, Wei-Kian; Lin, Chao‐Hsu; Cheng, Bi-Wen; Lee, Yann-Jinn

doi:10.1016/j.pedneo.2020.12.001

Cited by 16 publications

(21 citation statements)

References 25 publications

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“…Compared to the baseline (0-min) model, the 30-min model improved the specificity (0.682 vs. 0.910), which is necessary for a diagnostic test to identify true negatives (girls without CPP). However, its specificity was equal to those of As stated, the LH obtained after 30-or 40-min post-stimulation was recommended to diagnose CPP with an extensive range of sensitivity and specificity (90%-99% and 81%-100%, respectively [2,16,17,31,32] regardless of the machine learning application. Pan et al [19,20] and Wenyong et al [33] firstly applied machine learning to propose a prescreening tool for CPP in girls, but they solely determined baseline clinical characteristics without taking the GnRHa stimulation test.…”

Section: Comparison Of Different Time Points Used In the Models For Cpp In Girlsmentioning

confidence: 95%

Development and Validation of Clinical Diagnostic Model for Girls with Central Precocious Puberty: Machine-learning Approaches

Huynh

Huang

et al. 2022

PLoS ONE

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Background A brief gonadotropin-releasing hormone analogues (GnRHa) stimulation test which solely focused on LH 30-minute post-stimulation was considered to identify girls with central precocious puberty (CPP). However, it was tested using traditional statistical methods. With advanced computer science, we aimed to develop a machine learning-based diagnostic model that processed baseline CPP-related variables and a brief GnRHa stimulation test for CPP diagnosis. Methods We recruited girls suspected of precocious puberty and underwent a GnRHa stimulation test at Children Hospital 2, Vietnam, and Cathay General Hospital, Taiwan. Clinical data, bone age measurement, and 30-min post-stimulation blood test were used to build up the predictive model. The candidate model was developed by different machine learning algorithms that were mainly evaluated by sensitivity, specificity, the area under the receiver operator characteristic curve (AUC), and F1-score in internal and external validation data to classify girls as CPP and non-CPP at different time-points (0-min, 30-min, 60-min, and 120-min post-stimulation). Results Among the 614 girls diagnosed with PP, 524 (85.3%) had CPP. The random forest algorithm yielded the highest value of F1-score (0.976), specificity (0.893), positive predicted value (0.987), and relatively high value of AUC (0.972) that contributed to high probability to identify CPP. The performance metrics of the 30-min post-stimulation diagnostic model including sensitivity and specificity surpassed those of the 0-minute model (0-min) and were equivalent to those of the model obtained 60-min and 120-min post-stimulation. Hence, our machine learning-based model helps shorten the stimulation test to 30 minutes after GnRHa injection, in general, it requires 120 minutes for a completed GnRHa stimulation test. Conclusions We developed a diagnostic model based on clinical features and a single sample 30-minute post-stimulation to identify CPP in girls that can reduce distress for children caused by multiple blood samplings.

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Section: Comparison Of Different Time Points Used In the Models For Cpp In Girlsmentioning

confidence: 95%

Development and Validation of Clinical Diagnostic Model for Girls with Central Precocious Puberty: Machine-learning Approaches

Huynh

Huang

et al. 2022

PLoS ONE

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“…The baseline LH level is a promising biomarker to diagnose CPP (31); a basal morning LH value of more than 0.2 mUI/ml is usually considered indicative of puberty (28,(31)(32)(33)(34)(35)(36)(37). In addiction, an LH to FSH ratio higher than 0.6 has been associated with CPP (31,34).…”

Section: Precocious Pubertymentioning

confidence: 99%

Precocious puberty and microbiota: The role of the sex hormone–gut microbiome axis

et al. 2022

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Puberty is a critical phase of life associated with physiological changes related to sexual maturation, and represents a complex process regulated by multiple endocrine and genetic controls. Puberty is driven by hormones, and it can impact the gut microbiome (GM). GM differences between sex emerge at puberty onset, confirming a relationship between microbiota and sex hormones. In this narrative review, we present an overview of precocious pubertal development and the changes in the GM in precocious puberty (PP) in order to consider the role of the sex hormone–gut microbiome axis from the perspective of pediatric endocrinology. Bidirectional interactions between the GM and sex hormones have been proposed in different studies. Although the evidence on the interaction between microbiota and sex hormones remains limited in pediatric patients, the evidence that GM alterations may occur in girls with central precocious puberty (CPP) represents an interesting finding for the prediction and prevention of PP. Deepening the understanding of the connection between the sex hormones and the role of microbiota changes can lead to the implementation of microbiota-targeted therapies in pubertal disorders by offering a pediatric endocrinology perspective.

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“…Earlier secretion of E 2 and other sex hormones acceler-ate bone maturation, resulting in shortened bone growth cycle and reduced bone mineral density (Khosla & Monroe, 2018;Manolagas et al, 2002). Therefore, LH, FSH, E 2 and GnRH stimulation test have been used as intuitive clinical indexes to diagnose PP (Yeh et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Timosaponin AIII attenuates precocious puberty in mice through downregulating the hypothalamic-pituitary-gonadal axis

Zhou

Ren

et al. 2023

Acta Biochim Pol

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Precocious puberty (PP) has increasingly become a social concern. This study aimed to investigate the effect of timosaponin AIII (TAIII) on the precocious puberty and its possible mechanisms in mice. Four groups of mice consisting of controls that received saline or TAIII, a model that received leptin to induce precocious puberty (PP), and leptin+TAIII (the leptin model treated with TAIII) were used to determine the effect of TAIII on PP. Pathological and cytological examinations were conducted to investigate the signs and onset of PP and the development of reproductive organs. The level of serum luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E2) were determined using enzyme-linked immunosorbent assay (ELISA). The expression of genes related to the hypothalamic-pituitary-gonadal axis (HPGA) was assessed using qRT-PCR and Western blotting. Bone mineral density (BMD) was determined using high resolution peripheral quantitative computed tomography. In mice treated with leptin, earlier vaginal opening and estrus were observed, as well as the increased ovarian and uterine weight, total uterine cross-sectional size, number of corpora lutea, and elevated serum sex hormone levels and HPGA expression. On the other hand, TAIII treatment delayed the vaginal opening and vaginal estrus to 32.1 and 37.5 days after birth, and delayed the development of reproductive organs, leading to significantly smaller uterus and ovary size, less corpora lutea and low BMD (P<0.05). In addition, the serum levels of LH, FSH and E2 were significantly reduced (P<0.05) and so was the expression of HPGA and leptin genes (P<0.05). Our experimental data demonstrated that TAIII has activity against leptin-induced PP activity and may attenuate PP by reducing reproductive hormones and deactivating the hypothalamic-pituitary-gonadal axis through downregulating leptin expression.

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Diagnostic evaluation of central precocious puberty in girls

Cited by 16 publications

References 25 publications

Development and Validation of Clinical Diagnostic Model for Girls with Central Precocious Puberty: Machine-learning Approaches

Development and Validation of Clinical Diagnostic Model for Girls with Central Precocious Puberty: Machine-learning Approaches

Precocious puberty and microbiota: The role of the sex hormone–gut microbiome axis

Timosaponin AIII attenuates precocious puberty in mice through downregulating the hypothalamic-pituitary-gonadal axis

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