New Children's Hospital, Pediatric Research Center, Helsinki University Hospital, Helsinki 00014, Finland.
Stem Cells and Metabolism Research Program, Research Program Unit, University of Helsinki, Helsinki 00014, Finland.
Eur J Endocrinol. 2024 Mar 2;190(3):211-219. doi: 10.1093/ejendo/lvae021.
Recent studies suggest that boys enter puberty at a younger age, and the incidence of male central precocious puberty (CPP) is increasing. In this study, we explore the incidence of male CPP and identify key clinical and auxological indicators for organic CPP (OCPP).
A retrospective registry-based study.
The medical records of 43 boys treated with CPP at the Helsinki University Hospital between 1985 and 2014 were reviewed. Clinical, auxological, and endocrine data of the CPP patients were included in the analyses.
Based on brain MRI, 26% of patients had OCPP. Between 2010 and 2014, the CPP incidence in boys was 0.34 per 10 000 (95% CI 0.20-0.60). Between 1990 and 2014, the male CPP incidence increased (incidence rate ratio [IRR] 1.10, P = .001). This increase was driven by rising idiopathic CPP (ICPP) incidence (IRR 1.11, 95% CI 1.05-1.19, P < .001), while OCPP incidence remained stable (P = .41). Compared with the patients with ICPP, the patients with OCPP were younger (P = .006), were shorter (P = .003), and had higher basal serum testosterone levels (P = .038). Combining 2 to 4 of these readily available clinical cues resulted in good to excellent (all, area under the curve 0.84-0.97, P < .001) overall performance, differentiating organic etiology from idiopathic.
The estimated incidence of CPP in boys was 0.34 per 10 000, with 26% of cases associated with intracranial pathology. The increase in CPP incidence was driven by rising ICPP rates. Patients with OCPP were characterized by shorter stature, younger age, and higher basal testosterone levels, providing valuable cues for differentiation in addition to brain MRI. Utilizing multiple cues could guide diagnostic decision-making.
最近的研究表明，男孩进入青春期的年龄更小，男性中枢性性早熟（CPP）的发病率正在增加。本研究旨在探讨男性 CPP 的发病率，并确定有机 CPP（OCPP）的关键临床和生长学指标。
基于回顾性注册的研究。
对 1985 年至 2014 年间在赫尔辛基大学医院接受 CPP 治疗的 43 名男孩的病历进行了回顾性分析。对 CPP 患者的临床、生长学和内分泌数据进行了分析。
根据脑 MRI，26%的患者患有 OCPP。2010 年至 2014 年，男孩中 CPP 的发病率为 0.34/10000（95%CI 0.20-0.60）。1990 年至 2014 年，男性 CPP 的发病率增加（发病率比[IRR]1.10，P=0.001）。这种增加是由特发性 CPP（ICPP）发病率的上升驱动的（IRR 1.11，95%CI 1.05-1.19，P<0.001），而 OCPP 的发病率保持稳定（P=0.41）。与 ICPP 患者相比，OCPP 患者年龄更小（P=0.006）、身高更矮（P=0.003）、基础血清睾酮水平更高（P=0.038）。将这些易于获得的临床线索中的 2 至 4 个相结合，可获得良好至优秀的整体表现（所有曲线下面积为 0.84-0.97，P<0.001），从而将有机病因与特发性病因区分开来。
男孩 CPP 的估计发病率为 0.34/10000，其中 26%的病例与颅内病变有关。CPP 发病率的增加是由 ICPP 发病率的上升驱动的。OCPP 患者的特征是身材矮小、年龄较小、基础睾酮水平较高，除了脑 MRI 外，还提供了有价值的鉴别线索。利用多个线索可以指导诊断决策。
