Insulin-like Growth Factor 1, but Not Insulin-Like Growth Factor-Binding Protein 3, Predicts Central Precocious Puberty in Girls 6–8 Years Old: A Retrospective Study

Abstract

<b><i>Background:</i></b> Central precocious puberty (CPP) in females is characterized by thelarche before 8 years of age. Evidence of reproductive axis activation confirms the diagnosis (basal serum luteinizing hormone (LH) ≥0.3 IU/L or LH-releasing hormone (LHRH)-stimulated LH ≥5 IU/L). Stimulation testing is the diagnostic gold standard but is time-consuming and costly. Serum levels of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-binding protein 3 (IGFBP-3) are increased in girls with CPP. <b><i>Objective:</i></b> The aim of the study was to assess the utility of serum IGF-1 and IGFBP-3 in identifying CPP in girls aged 6–8 years. <b><i>Methods:</i></b> The study was a single-center retrospective study. Girls with confirmed CPP (<i>n</i> = 44) and isolated premature precocious adrenarche/ precocious thelarche (PA/PT, <i>n</i> = 16) had baseline biochemical profiling and LHRH stimulation testing. Serum IGF-1 and IGFBP-3 results were converted to standard deviation scores (SDS). Correlations were calculated and receiver operating characteristic curves were plotted. <b><i>Results:</i></b> Girls with CPP had higher basal and peak LH, IGF-1 SDS, and growth velocity (<i>p</i> < 0.05). IGF-1 SDS correlated positively with basal and peak LH (<i>p</i> < 0.05). IGF-1 SDS (1.75–2.15) differentiated CPP and PA/PT with 89% sensitivity and 56% specificity (basal LH) and 94% specificity and 55% sensitivity (peak LH). IGFBP-3 SDS did not differ between groups or by CPP parameters. <b><i>Conclusions:</i></b> In clinical practice, IGF-1 SDS may be an additional tool for identifying CPP in girls aged 6 to 8 years when baseline clinical and laboratory diagnostic criteria are inconclusive, possibly avoiding more time-consuming and costly procedures.

Early diagnostic value of serum IGF-1, FGF23 and Klotho in girls with rapidly progressive central precocious puberty

“…This study found that the IGF-1 of girls in the RP-CPP group was higher than that in the SP-CPP group. This study also found that in the RP-CPP group, the IGF-1 was positively correlated with the classical CPP parameter LH, which was consistent with the results of Escagedo et al [3] . On the one hand, IGF-1 plays a role in inducing the proliferation of chondrocytes and osteoblasts to regulate linear growth in the process of human puberty, on the other hand, it can also regulate the HPG axis by regulating the central nervous system.…”

“…Puberty development is regulated by the GH-IGF-1 axis and HPGA. Activation of the HPG axis promoted the secretion of GH and IGF-1, and estrogen further promoted the secretion of GH, resulting in increased concentrations and enhanced effects of IGF-1 in the growth plate [3] . Studies have found that IGF-1 stimulates a peptidergic pathway within the medial basal hypothalamus (MBH) to eliminate the inhibition of GnRH secretion before puberty, and IGF-1 seems to play a role in activating and enhancing GnRH secretion during puberty [4] .…”

Integrated analysis of proteomics and metabolomics in girls with central precocious puberty

“…In order to find the core proteins that are linked to CPP, the top 25 proteins with connectivity were selected to construct a PPI network and IGF-1 was found to have the highest connectivity. IGF-1 has been previously shown to have a predictive role as a biomarker in the diagnosis of girls with CPP ( 27 ). IGF2 and IGFBP1 were also thought to be involved in the process of puberty ( 28 , 29 ).…”