Insulin-like growth factor 1 as a diagnostic marker of progressive central precocious puberty: a prospective study

• Type: Article in International Scientific Journal
• Date: 2025

Authors

Leite, AL (Author) Other; Azevedo L (Author) FMUP; Campos, RA (Author) Other; Rangel, MA (Author) Other; Torres, C (Author) Other; Santos, FM (Author) Other; Aires, S (Author) Other; Firmino Machado, J (Author) Other; Limbert, C (Author) Other

Journal

Title: European Journal of Pediatrics

Vol. 184

ISSN: 0340-6199

Publisher: Springer Nature

Indexing

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Other information

Authenticus ID: P-019-6HD

DOI: 10.1007/s00431-025-06276-5

Abstract (EN): Central precocious puberty (CPP) diagnosis often requires invasive GnRH stimulation tests. Our purpose was to determine whether the IGF-1 and IGF-1 SDSs are reliable predictors of progressive CPP. This was a prospective study including 82 girls under 8 years of age. The participants were divided into CPP (n = 39), NP-CPP and IT (n = 26), and control groups (n = 17). Anthropometric measurements, Tanner staging, bone age, pelvic ultrasound, and serum IGF1 and IGF1-SDS level measurements were performed. GnRH stimulation tests confirmed CPP cases. The mean IGF1 and IGF1-SDS levels were significantly greater in CPP patients (270.15 ng/mL; 1.943 SDS) than in NP-CPP patients (174.12 ng/mL; 0.788 SDS) and controls (139.28 ng/mL; 0.208 SDS) (p < 0.001). Multivariate logistic regression analysis confirmed that IGF1 (OR = 1.025, 95% CI 1.010-1.040) and IGF1-SDS (OR = 8.721, 95% CI 2.624-28.986) were significant predictors of CPP. ROC analysis revealed an AUC of 0.837 for IGF1 (95% CI 0.738-0.935) and 0.862 for IGF1-SDS (95% CI 0.771-0.953). The cut-off values of 231 ng/mL for IGF1 (71.8% sensitivity, 97.7% specificity) and 1.44 for IGF1-SDS (79.5% sensitivity, 90.7% specificity) demonstrated good accuracy (82.2% and 77.8%, respectively). Conclusion: IGF1-SDS, and absolute IGF1, are promising effective noninvasive diagnostic markers for distinguishing CPP from nonprogressive precocious puberty. Due to its high specificity IGF1 values above 1.44, SDS may significantly increase the post-test probability of CPP, potentially avoiding invasive GnRH stimulation tests. These findings support the integration of IGF1 measurements into the initial diagnostic approach for girls presenting with early pubertal signs.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10