Endocrine Abstracts

JOINT3737

Introduction: The appearance of secondary sex characteristics 2-2.5 standard deviation score (SDS) earlier than the expected age is defined as precocious puberty. Childhood obesity has emerged as an important public health problem in recent years. GnRH stimulation test is considered the gold standard in the diagnosis of precocious puberty. Our study aims to determine possible differences in responses according to body mass index in female patients who underwent GnRH stimulation test with the preliminary diagnosis of precocious puberty.

Materials and Methods: In this retrospective study, female patients aged 6-9.5 years who applied to tertiary Pediatric Endocrinology clinic between September 2022 and December 2023 and underwent GnRH stimulation test with the preliminary diagnosis of precocious puberty were included. Patients were grouped according to their BMI SDS values as normal weight (BMI SDS between -1.5 and +1.5), overweight (BMI SDS between +1.5 and +2) and obese (BMI SDS > +2). Detailed anamnesis of the patients was taken and their demographic data, anthropometric measurements, laboratory results and radiological imaging were evaluated.

Results: Among the 241 girls included in the study, 147 (60.99%) were of normal weight, 46 (19.08%) were overweight, and 48 (19.91%) were obese. The mean chronological age of all cases was 7.8 ± 0.66 years, the mean bone age was 9.4 ± 1.2 years, and the mean height age was 8.7 ± 1.28 years. When comparing the three groups, no significant difference was found in chronological ages. However, there was a difference in bone ages and height ages (P < 0.05). While there was no significant difference in basal LH and E2 levels, a difference was found in basal FSH levels (P < 0.05). Differences were also observed in peak LH and peak FSH responses (P < 0.05).

Discussion: In our study, the test results of patients who underwent GnRH stimulation test with the preliminary diagnosis of precocious puberty were evaluated according to their BMI SDS, and a difference was detected between the groups in peak LH and peak FSH responses. The low peak LH responses in overweight and obese patients as a result of the GnRH stimulation test performed when basal LH levels are not sufficient to make a diagnosis indicate that it may be more appropriate to evaluate the results of the GnRH stimulation test, which is considered the gold standard test in terms of pre-puberty, together with other test results in these patients.