Journal of the Endocrine Society · 2026
Distinguishing central precocious puberty from nonprogressive breast development: adiposity and DXA body composition.
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Fava Daniela, Casirati Amanda, Calevo Maria Grazia, Angelelli Alessia, Pepe Alessia, Maiorano Nadia Gabriella, Acquarone Lucia, Santucci Chiara, Caridi Claudia, Tosto Valentina, Panciroli Marta, Tedesco Caterina, Napoli Flavia, Allegri Anna Elsa Maria, Patti Giuseppa, Naim Alessandro, Gastaldi Roberto, Maghnie Mohamad, Di Iorgi Natascia
Аннотация
OBJECTIVE: Distinguishing central precocious or early puberty (CPP/EP) from nonprogressive premature breast development (npPBD) is challenging, particularly in the context of increasing childhood adiposity, which may affect growth and skeletal maturation independently of hypothalamic-pituitary-ovarian (HPO) axis activation.
METHODS: We retrospectively evaluated 100 girls (69 CPP/EP, 31 npPBD) and 16 age-matched prepubertal girls with obesity as controls. Assessments included auxology, bone age, hormonal and metabolic profiles, pelvic ultrasound, DXA-derived body composition, and lifestyle factors.
RESULTS: Anthropometric parameters and bone age were similar between CPP/EP and npPBD, whereas LH, FSH, estradiol, and IGF-1 SDS (all P < .001) remained the main discriminators between groups. Overall body composition was comparable, except for a higher android-to-gynoid fat ratio in npPBD (P = .03). In both diagnostic groups, overweight/obesity was associated with greater height relative to target height (P = .004 in CPP/EP; P = .03 in npPBD) and higher IGF-1 SDS (P < .001 and P = .02, respectively) compared with controls. Among normal-weight girls, those with CPP/EP showed greater height relative to target height (P = .009) and more advanced bone age (P = .02) than those with npPBD, whereas these differences were not observed in girls with overweight/obesity.
CONCLUSION: Excess adiposity reduces the diagnostic specificity of auxological and skeletal maturation parameters in girls with early breast development. Biochemical assessment remains central, with IGF-1 SDS providing additional supportive information.
METHODS: We retrospectively evaluated 100 girls (69 CPP/EP, 31 npPBD) and 16 age-matched prepubertal girls with obesity as controls. Assessments included auxology, bone age, hormonal and metabolic profiles, pelvic ultrasound, DXA-derived body composition, and lifestyle factors.
RESULTS: Anthropometric parameters and bone age were similar between CPP/EP and npPBD, whereas LH, FSH, estradiol, and IGF-1 SDS (all P < .001) remained the main discriminators between groups. Overall body composition was comparable, except for a higher android-to-gynoid fat ratio in npPBD (P = .03). In both diagnostic groups, overweight/obesity was associated with greater height relative to target height (P = .004 in CPP/EP; P = .03 in npPBD) and higher IGF-1 SDS (P < .001 and P = .02, respectively) compared with controls. Among normal-weight girls, those with CPP/EP showed greater height relative to target height (P = .009) and more advanced bone age (P = .02) than those with npPBD, whereas these differences were not observed in girls with overweight/obesity.
CONCLUSION: Excess adiposity reduces the diagnostic specificity of auxological and skeletal maturation parameters in girls with early breast development. Biochemical assessment remains central, with IGF-1 SDS providing additional supportive information.