Clinical and Laboratory Findings and Ultrasound Assessment in the Differential Diagnosis of Central Precocious Puberty and Premature Thelarche / 医学研究杂志

ABSTRACT

Objective The differential diagnosis of female precocious puberty (PP) and premature breast development (PT) was made by ultrasound and related hormone levels,so as to provide the basis for clinical diagnosis.Methods In this study,from 2015 to 2016 due to early breast enlargement (age ＜ 8 years) to our hospital pediatric patients with children,according to the diagnostic criteria were divided into PP group and PT group.Ultrasonography was performed on all patients and graded according to the criteria.At the same time,the levels of clinical and hormones were compared between the two groups.ROC analysis was used to identify the significant differences.Results In this study,a total of 60 cases of female children,including PP and PT children were 30 cases.Ultrasonic breast grading was positively correlated with age,BA,BD,LH level,FSH level and E2 level,but there was no correlation between BA/CA.There was no statistical difference between the breast ultrasound and the breast diameter (P ＜ 0.05).The levels of LH and FSH,basal LH/ FSH,LF and FSH peak and LH/FSH peak in the PP group were significantly higher than those in the PT group (P ＜ 0.05).The ROC analysis found 100％ sensitivity and 85％ specificity for LH/FSH peak ＞0.25 for diagnosis of PP,with a 72％ sensitivity and a specificity of 65％ for basal LH ＞ 0.1 mIU/ml.The SHBG level was the only one that did not overlap [PP80.6 (62.3-95.4) vs PT114.5 (107.6-121.5)].There was no significant difference in kisspeptin,leptin and neurokinin B between the two groups (P ＞ 0.05).Conclusion Breast ultrasound by grading and measurement of breast buds can be effective in evaluating the development of female precocious puberty breast development,but can not identify PP and PT.The study found that SHBG concentration and peak ratio of LH/FSH can effectively identify PP and PT,but kisspeptin,neurokinin B and leptin is not enough to identify PP and PT.