Endocrine Abstracts

Objective: The distinction between constitutional delay of growth and puberty (CDGP) and congenital hypogonadotropic hypogonadism (CHH) in males with delayed puberty is difficult but important for timely treatment. We aimed to summarize the sensitivity and specificity of serum inhibin B (INHB) level in distinguishing CHH with CDGPin boys.

Methods: Studies in the PubMed, EMBASE and Cochrane Library databases were systematically searched from the date of database inception to November 10, 2019.Studies incorporating INHB discriminating between CHH and CDGP were included. The quality assessment of diagnostic studies 2 (-QUADAS-2) instrument was used to assess the quality of the included studies. Meta-Disc version 1.4. was used to calculate the sensitivity, specificity, summary receiver-operating characteristic (sROC) curves, and area under the curve (AUC).

Results: Six studies, comprising 328 patients (87 CHH vs 241CDGP), were eligible for this meta-analysis. For the differential diagnosis between CHH and CDGP, INHB measurement had a good diagnostic accuracy with a pooled sensitivity of 92%, specificity of 91%, pooled AUC of 0.9616. INHB performed well especially in CHH and CDGP boys with severe puberty deficiency (testes volume ≤3 ml), with sensitivity of 92%, specificity of 98% and AUC of 0.9956.Subgroup analysis weredisplayed in Table 1.

Conclusions: INHB has an excellent diagnostic performance in differentiating CHH from CDGP, retaining both considered sensitivity and specificity. INHB has better diagnostic efficacy in boys with severe puberty deficiency (testes volume ≤3 ml). (Grant/Award Number: 201604020090, Guangzhou Science and Technology Programme)

Keywords: Inhibin B, congenital hypogonadotropic hypogonadism, constitutional delay of growth and puberty, meta-analysis.