Thyroid Function In Girls With Central Precocious Puberty

Presentation Number: SUN-183
Date of Presentation: March 18, 2018, 2018

Young Jun Rhie, MD, PhD1, Hyo-Kyoung Nam, MD, PhD2, Kee-Hyoung Lee, MD,PHD3.
1Korea University Ansan Hospital, Ansan, Korea, Republic of, 2Korea Univ Guro Hosp, Seoul, Korea, Republic of, 3Korea Univ Anam Hosp, Seoul, Korea, Republic of.


Objectives: Obesity is a well-known risk factor for central precocious puberty (CPP). Recently, elevated thyroid stimulating hormone (TSH) were reported in obese youth. However, few data regarding the relationship between CPP and TSH are available. The aim of this study was to evaluate thyroid function in girls with CPP and the relationship between CPP and serum TSH concentration. Methods: This is a retrospective cross-sectional study. A total 1,247 girls aged 6-9 years who underwent gonadotropin-releasing hormone (GnRH) stimulation test to determine the presence of puberty were participated this study. Medical records of all subjects were reviewed. Subjects were classified into CPP (n=554) and control (n=693) groups according to the results of GnRH stimulation test. Subclinical hypothyroidism was defined as elevated TSH with normal fT4 (TSH ≥ 5.0 mIU/L and fT4 ≥ 0.8 ng/dL). Characteristic and laboratory data between CPP and control groups were compared. Correlations of characteristic and laboratory data with TSH concentration were evaluated. Results: There were no significant differences in age, height, height standard deviation score (SDS), insulin-like growth factor binding protein (IGFBP)3 and IGFBP3 SDS between CPP and control groups. Bone age, bone age advance, alkaline phosphatase (ALP), insulin-like growth factor (IGF)1, IGF1 SDS, basal and peak luteinizing hormone (LH) and basal and peak follicular stimulating hormone (FSH) were significantly higher in CPP than in control group. Weight, weight SDS, body mass index (BMI) and BMI SDS were significantly higher in control than CPP group. Serum TSH concentration of CPP group was significantly higher than that of control group (3.19 ± 1.55 vs. 2.58 ± 1.34 mIU/L, p<0.001). Serum fT4 concentration of CPP group was significantly lower than that of control group (1.38 ± 0.14 vs. 1.44 ± 0.18 ng/dL, p<0.001). Among all subjects, 149 girls (11.9%) had subclinical hypothyroidism. The prevalence of subclinical hypothyroidism was higher in CPP group compared to control group (15.7 vs. 8.9%, p<0.001). TSH concentrations were positively correlated with age, height, weight, BMI, bone age, ALP, IGF1, IGF1 SDS, basal LH, peak LH and basal FSH. Multiple linear regression analysis showed that age (β = 0.574, p<0.001) and peak LH (β = 0.016, p = 0.021) were independent predictors of serum TSH concentration.Conclusion: Subclinical hypothyroidism in girls with CPP should be associated with pubertal LH elevation.


 Y. Rhie: None. H. Nam: None. K. Lee: None.