Correlation analysis of pituitary morphometry in boys with idiopathic central precocious puberty or early puberty: implications for diagnosis.

BACKGROUND

Idiopathic central precocious puberty (ICPP) and early puberty (EP) in boys affect growth and development. While brain magnetic resonance imaging (MRI) is routinely used to exclude organic causes, the diagnostic value of quantitative pituitary morphometry remains largely unexplored in male populations. This study aimed to investigate the associations between pituitary morphometry (including length, width, height, and volume) and ICPP or EP in boys, and to evaluate their potential as imaging biomarkers for diagnostic purposes.

METHODS

In this retrospective case-control study, boys who underwent evaluation for precocious puberty at the Department of Endocrinology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China between January 2015 and December 2024 and were subsequently diagnosed with ICPP or EP were enrolled. Age-matched healthy boys served as controls. Pituitary dimensions (length, width, height) and volume were measured by contrast-enhanced MRI. Spearman correlation analyzed their relationships with sex hormones and gonadal development. Multivariable logistic regression evaluated associations with ICPP/EP, with restricted cubic spline (RCS) regression exploring nonlinear trends.

RESULTS

A total of 354 boys were enrolled: 118 in the case group (ICPP/EP) and 236 in the healthy control group. The median age of the case group was 9.86 years, among whom 24.6% (29/118) were obese and 11.9% (14/118) were overweight. The case group exhibited significantly greater pituitary width and volume compared with the control group (width: 11.80 vs. 10.90 mm, P<0.001; volume: 201.50 vs. 165.58 mm3, P<0.001). In the case group, pituitary width and volume were significantly correlated with serum levels of luteinizing hormone and testicular volume (P<0.05). For boys with ICPP/EP, a pituitary width >13 mm or a volume >240 mm3 was associated with an increased risk of ICPP/EP.

CONCLUSIONS

Increased pituitary width and volume in boys with ICPP/EP are associated with elevated serum LH levels and testicular volume, suggesting their potential as imaging biomarkers for the clinical diagnosis of ICPP/EP. Further research is needed to validate these findings.