Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.
Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, P.le Brescia 20, 20149, Milan, Italy.
J Endocrinol Invest. 2024 Feb;47(2):315-323. doi: 10.1007/s40618-023-02146-9. Epub 2023 Aug 11.
The aim of our study was to compare the incidence of idiopathic central precocious puberty (CPP) in our highly specialized Endocrinological Center before and after the onset of COVID-19 lockdown; we also aimed to identify any potential difference between girls with CPP from the two different time periods.
We retrospectively analyzed the auxological profile of 49 girls with idiopathic CPP: 30 with pre-lockdown onset and 19 with post-lockdown onset of the disease. We collected patients' characteristics (medical history, physical examination, baseline and dynamic hormonal assessment, bone age, pelvic ultrasound) and compared them between the two groups.
We registered an almost threefold increase in CPP incidence in the 2020-2021 period compared to the previous six years. In post-lockdown patients we found a trend for an earlier diagnosis in terms of both chronological age (p 0.0866) and days between the onset of first pubertal signs and diagnosis (p 0.0618). We also found that post-lockdown patients had a significantly lower hypothalamus-pituitary-gonadal axis activation (lower ∆LH% after GnRH test, p 0.0497), a significantly lower increase in bone age calculated at RUS with TW3 method (p 0.0438) and a significantly reduced ovarian activation in females (lower delta-4-androstenedione levels, p 0.0115). Interestingly, post-lockdown patients were born from mothers with an older age at menarche (p 0.0039).
Besides confirming a significant increase in new diagnoses of CPP in the post-lockdown period, our findings among Post-lockdown girls also suggest a less progressive form of CPP and a stronger environmental influence compared to genetic background in determining the timing of pubertal onset.
本研究旨在比较 COVID-19 封锁前后我们高度专业化的内分泌中心特发性中枢性性早熟 (CPP) 的发病率；我们还旨在确定两个不同时期 CPP 女孩之间是否存在任何潜在差异。
我们回顾性分析了 49 例特发性 CPP 女孩的生长学特征：30 例发病前封锁，19 例发病后封锁。我们收集了患者的特征（病史、体格检查、基线和动态激素评估、骨龄、骨盆超声），并将两组进行了比较。
与前六年相比，我们在 2020-2021 年期间登记的 CPP 发病率几乎增加了三倍。在后封锁组患者中，我们发现无论是在实际年龄（p 0.0866）还是从第一性征出现到诊断的天数（p 0.0618）方面，诊断都有提前的趋势。我们还发现，后封锁组患者的下丘脑-垂体-性腺轴激活程度较低（GnRH 试验后 ∆LH%较低，p 0.0497），用 TW3 法计算的桡骨远端骨龄增加幅度较低（p 0.0438），女性卵巢激活程度较低（delta-4-雄烯二酮水平较低，p 0.0115）。有趣的是，后封锁组患者的母亲初潮年龄较大（p 0.0039）。
除了证实封锁后时期 CPP 的新诊断显著增加外，我们在后封锁组女孩中的发现还表明，与遗传背景相比，CPP 的形式不太具有进展性，并且在确定青春期开始的时间方面，环境影响更强。
