Objective To explore the role of kisspeptin in identifying the activation of the hypothalamic-pituitary-gonadal axis (HPGA),in order to simplify the diagnostic process for precocious puberty. Methods A total of 54 girls who presented with breast development as the main complaint in the pediatric outpatient clinic of West China Second Hospital from June 2021 to June 2023 were selected as the study subjects.Physical examination,laboratory tests,and imaging examinations were conducted.The level of kisspeptin was detected using an enzyme-linked immunosorbent assay (ELISA) kit.The diagnostic value of kisspeptin in discerning the initiation of HPGA was determined via receiver operating characteristic (ROC) curve analysis. Results Significant differences in kisspeptin levels were observed among central precocious puberty (CPP),rapidly progressive puberty (RPP),and premature thelarche (PT) groups (H=14.147,P=0.003).Spearman correlation analysis revealed positive correlations between kisspeptin level and parameters such as height,weight,bone age,basal luteinizing hormone(LH),basal follicle-stimulating hormone(FSH),peak LH in gonadotropin-releasing hormone (GnRH) stimulation test,and LH/FSH peak ratio (P<0.05),with the largest correlation coefficients for LH peak (rs=0.479) and LH/FSH peak ratio (rs=0.507).The ROC curve showed that the area under the curve (AUC) of kisspeptin was 0.702 (95%CI:0.570 - 0.834).When the cut-off value was 310.38ng/mL,the Youden index was maximized (0.418),with a sensitivity and specificity of 81.8% and 60.0%,respectively. Conclusion Kisspeptin has diagnostic significance in differentiating the initiation of HPGA,and it can be used as an auxiliary diagnostic indicator or preliminary screening indicator,which can provide certain references and direction for simplifying the diagnosis procedure of precocious puberty in the future.
Key words
kisspeptin /
central precocious puberty /
rapidly progressive puberty /
hypothalamic-pituitary-gonadal axis /
ROC curve
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