Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
Department of Pediatrics, SMG-SNU Boramae Medical Center, Seoul, Korea.
J Pediatr Endocrinol Metab. 2022 Aug 9;35(9):1177-1182. doi: 10.1515/jpem-2022-0093. Print 2022 Sep 27.
Prolactin (PRL) stimulates the mammary glands development; however, it also inhibits gonadotropin-releasing hormone (GnRH) secretion. We evaluated the relationship between PRL levels and puberty in girls with precocious breast development.
This study included 244 girls with breast development < 8 years of age. Patients were categorized as central precocious puberty (CPP) [peak luteinizing hormone (LH) levels ≥ 5 IU/L after GnRH stimulation] versus non-CPP (NPP) group. High PRL was defined as serum PRL > 17.9 ng/mL.
High PRL was more common in NPP than in CPP group (17.6 vs. 8.1%, p=0.025), although mean PRL levels did not differ. In NPP group, the high PRL group had lower peak LH/follicle-stimulating hormone (FSH) ratio, and later LH peak time after GnRH stimulation than normal PRL group (all p < 0.05). PRL levels of the subgroups according to the peak LH time (15, 30, 45, 60, and 90 min after GnRH stimulation) were different in NPP group, but not in CPP group. PRL levels tended to be higher as the peak LH time was delayed. High PRL was associated with decreased odds for CPP (OR=0.42, p=0.043).
Girls with NPP showed higher proportion of high PRL than CPP group. High PRL group showed more features of prepubertal response in NPP group, and associated with decreased odds for CPP, suggesting the possibility of PRL role on breast development while suppressing hypothalamic-pituitary-gonadal axis activation in NPP girls.
催乳素（PRL）可刺激乳腺发育，但也可抑制促性腺激素释放激素（GnRH）的分泌。我们评估了催乳素水平与性早熟女孩青春期之间的关系。
本研究纳入了 244 名 8 岁以下乳房发育的女孩。患者分为中枢性性早熟（CPP）[GnRH 刺激后黄体生成素（LH）峰值≥5IU/L]和非 CPP（NPP）组。高催乳素定义为血清 PRL>17.9ng/mL。
NPP 组高催乳素的发生率高于 CPP 组（17.6% vs. 8.1%，p=0.025），尽管两组的平均催乳素水平没有差异。在 NPP 组中，高催乳素组 GnRH 刺激后 LH/卵泡刺激素（FSH）峰值比正常催乳素组低，LH 峰值时间也较晚（均 p<0.05）。根据 LH 峰值时间（GnRH 刺激后 15、30、45、60 和 90 分钟）分组的亚组的催乳素水平在 NPP 组中存在差异，但在 CPP 组中没有差异。催乳素水平随着 LH 峰值时间的延迟而升高。高催乳素与 CPP 的可能性降低相关（OR=0.42，p=0.043）。
NPP 女孩中高催乳素的比例高于 CPP 组。NPP 组中高催乳素组表现出更多的青春期前反应特征，与 CPP 的可能性降低相关，提示催乳素在 NPP 女孩抑制下丘脑-垂体-性腺轴激活的同时，对乳房发育可能有一定作用。
