Akinci Ayşehan, Cetin Dilek, Ilhan Nevin
İnönü University, Turgut Özal Medical Center, Department of Paediatric Endocrinology, Malatya, Turkey.
J Clin Res Pediatr Endocrinol. 2012 Jun;4(2):61-5. doi: 10.4274/jcrpe.615.
Premature thelarche (PT) is defined as isolated breast development without secondary sex characteristics in girls below the age of eight. We aimed to determine whether the level of kisspeptin, which plays a role in the release of gonadotropins, is associated with PT.
The patient group included children with PT aged 3-8 years (n=20) and the control group included healthy children in the same age range (n=20). Height standard deviation scores (HSDSs), bone maturation and growth velocity were evaluated in the two groups. Basal follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), and sex hormone-binding globulin (SHBG) levels were also measured in the two groups by immunochemiluminometric assay (ICMA). A gonadotropin-releasing hormone (GnRH) test was also conducted in the patient group and the peak levels of FSH and LH were determined. Kisspeptin levels were measured using enzyme immunoassay (EIA).
No differences were found between the groups in terms of age, HSDS, annual growth rate and bone age. While the plasma basal FSH, LH and E2 levels in the patient and control groups did not show statistically significant differences, PRL levels were higher in the patient group (p<0.05). Peak LH response to GnRH test was at the prepubertal level (<5 ng/mL) in patients with PT. In the patient group, kisspeptin levels were significantly higher compared to the levels in the control group (2.96 ± 1.21 ng/dL vs. 1.19 ± 0.41 ng/dL, p<0.05), and kisspeptin levels showed a significant correlation with PRL, FSH, LH, and E2 levels (p<0.05).
In this study, plasma kisspeptin levels were found to be higher in patients with PT and to show a positive correlation with increased PRL levels. Kisspeptin is one of the neuropeptides that plays a role in the onset of puberty. Our results support the hypothesis that PT may result from the temporary activation of central stimulants.
性早熟(PT)定义为8岁以下女孩出现孤立性乳房发育且无第二性征。我们旨在确定在促性腺激素释放中起作用的 kisspeptin 水平是否与性早熟相关。
患者组包括3 - 8岁的性早熟儿童(n = 20),对照组包括同年龄范围的健康儿童(n = 20)。评估两组的身高标准差评分(HSDSs)、骨成熟度和生长速度。两组还通过免疫化学发光测定法(ICMA)测量基础促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、催乳素(PRL)和性激素结合球蛋白(SHBG)水平。患者组还进行了促性腺激素释放激素(GnRH)试验,并测定 FSH 和 LH 的峰值水平。使用酶免疫测定法(EIA)测量 kisspeptin 水平。
两组在年龄、HSDS、年生长率和骨龄方面未发现差异。患者组和对照组的血浆基础 FSH、LH 和 E2 水平无统计学显著差异,但患者组的 PRL 水平较高(p < 0.05)。性早熟患者对 GnRH 试验的 LH 峰值反应处于青春期前水平(<5 ng/mL)。患者组的 kisspeptin 水平显著高于对照组(2.96 ± 1.21 ng/dL vs. 1.19 ± 0.41 ng/dL,p < 0.05),且 kisspeptin 水平与 PRL、FSH、LH 和 E2 水平呈显著正相关(p < 0.05)。
在本研究中,发现性早熟患者的血浆 kisspeptin 水平较高,且与 PRL 水平升高呈正相关。Kisspeptin 是在青春期启动中起作用的神经肽之一。我们的结果支持性早熟可能由中枢刺激物的暂时激活引起这一假说。