SFEBES2026 Emerging Researcher and Plenary Orals Emerging Researcher Prize Lecture (Clinical) (1 abstracts)
Kisspeptin-54 accurately identifies the cause of delayed puberty
Maria Phylactou 1,2 , Kanyada Koysombat 1,2 , Megan Young 1,2 , Sandhi Nyunt 1,2 , Jovanna Tsoutsouki 1,2 , Arthur C. Yeung 1 , Pei C. Eng 3 , Sophie A. Clarke 4 , Edouard G. Mills 1,2 , Rachel Varughese 5,6 , Ruben H. Willemsen 6 , Jayanti Rangasami 7 , Evelien Gevers 6,8 , Alexander N. Comninos 1,2 , Sasha R. Howard 8,6 , Ali Abbara 1,2 & Waljit S. Dhillo 1,2
1Imperial College London, London, United Kingdom; 2Imperial College Healthcare NHS Trust, London, United Kingdom; 3National University of Singapore, Singapore, Singapore; 4University College London Hospital, London, United Kingdom; 5Queen Mary University Of London, London, United Kingdom; 6Barts Health NHS Trust, London, United Kingdom; 7Chelsea & Westminster NHS Foundation Trust, London, United Kingdom; 8Queen Mary University of London, London, United Kingdom
Background: Pubertal delay causes significant psychosocial distress for affected young people and their families, which is markedly exacerbated by diagnostic uncertainty. Delayed puberty is commonly due to self-limited delayed puberty (SLDP) but can be due to congenital hypogonadotrophic hypogonadism (CHH). Differentiating these two conditions is challenging and often takes years. The hypothalamus plays a key role in initiating puberty. Kisspeptin offers the possibility to directly interrogate hypothalamic function in humans and could offer a novel approach for identifying the cause of pubertal delay.
Methods: Twenty-two young people with delayed puberty (16 boys and 6 girls) were categorised into three groups according to pre-determined criteria (Group 1: likely SLDP, Group 2: likely CHH, Group 3: indeterminate pending follow-up). Participants received an intravenous bolus of kisspeptin-54 and GnRH on two separate occasions. Reproductive hormone levels were assessed every 15min for 6h (kisspeptin visit), and for 2h (GnRH visit). LH rise was compared between the three groups by Kruskal-Wallis test with post-hoc Dunn’s, and between SLDP and CHH by Mann-Whitney U test.
Results: Mean age (±SD) at time of assessment was 16.2 ±2.2 years. Seven boys had likely SLDP, 10 young people (4 boys and 6 girls) had likely CHH, whilst the remaining five were indeterminate (Group 3). Maximal rise in LH after kisspeptin-54 was higher in SLDP than CHH (SLDP: 3.39 ±1.16, CHH: 1.10 ±0.84, Indeterminate 3.46 ±2.40 IU/l; P-value = 0.0004). By contrast, LH responses after GnRH did not differ (P-value = 0.14). The LH-rise as early as 90 minutes following administration of kisspeptin-54 fully differentiated participants with SLDP from those with CHH (area under ROC curve 1.0; P-value = 0.0006), but not after GnRH (auROC 0.65; P-value = 0.33).
Summary: Kisspeptin-54 offers promise as a diagnostic test for delayed puberty to enable earlier identification of the underlying cause, which could expedite more timely and appropriate management.
Volume 117
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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