Objective: Central precocious puberty (CPP) causes early epiphyseal maturation, and early initiation of treatment improves final height. Unfortunately, there is no one parameter that can distinguish CPP from premature thelarche (PT), which is self-limited and requires no therapy. In animal models, kisspeptin, the ligand for the G-protein coupled receptor GPR54, was found to induce precocious activation of the gonadotrophic axis. Data on kisspeptin levels in girls with precocious puberty or in healthy prepubertal girls are lacking. We measured blood kisspeptin levels in girls with CPP and evaluated its potential as a clinical marker for CPP. Design This was a case-control study.
Patients: Thirty-one girls clinically diagnosed with CPP and 14 prepubertal age-matched healthy controls. Measurements Kisspeptin blood levels.
Results: Kisspeptin levels were significantly higher in the girls with CPP than in the controls: 14.62 +/- 10.2 pmol/l vs. 8.35 +/- 2.98 pmol/l, P < 0.05. Within the CPP group, there were no significant differences between the girls with a peak LH >5.0 IU/l and those with a peak LH </=5.0 IU/l regarding kisspeptin or any of the clinical, laboratory or ultrasound parameters, or in Tanner stage. No correlation was found between kisspeptin and body mass index standard deviation score (BMI-SDS) or height-SDS (Ht-SDS) for the entire cohort, or when analysed separately for the CPP group and the control group.
Conclusions: Although kisspeptin is significantly higher in girls with true CPP than in age-matched prepubertal controls, the evident overlap limits its use as a single diagnostic tool until further data obtained in larger studies should prove otherwise.