Translational pediatrics · 2026
Diagnostic value of serum inhibin B, anti-Müllerian hormone, and estradiol for central precocious puberty and early-fast puberty in girls: a cross-sectional study.
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Xu Lei, Zhang Haimeng, Huang Hui, Yang Li, Xie Liling, Zhang Dongguang, Yang Yu
Аннотация
BACKGROUND: Central precocious puberty (CPP) and early and fast puberty (EFP) in girls pose diagnostic challenges due to reliance on invasive gonadotropin-releasing hormone (GnRH) stimulation tests. Identifying non-invasive, cost-effective biomarkers is imperative for early detection and risk stratification. This study aimed to evaluate the diagnostic value of serum inhibin B (INHB), anti-Müllerian hormone (AMH), and estradiol (E2)-independent of uterine volume-for distinguishing CPP and EFP from premature thelarche and healthy controls.
METHODS: This retrospective cross-sectional study analyzed 423 girls [CPP: n=141; EFP: n=97; premature thelarche (PT): n=116; healthy controls: n=69] from Jiangxi Provincial Children's Hospital [2020-2022]. Clinical parameters, hormone levels (AMH, INHB, gonadotropins), uterine volume (UV), and ovarian volume (OV) were assessed. Diagnostic accuracy was evaluated via receiver operating characteristic (ROC) curves; biomarker relationships were examined using Spearman correlation.
RESULTS: Significant differences emerged across groups: CPP patients demonstrated lower AMH vs. PT (1.79 vs. 4.97 ng/mL, P<0.001) but higher INHB (32.20 vs. 21.75 pg/mL, P<0.001), while EFP showed elevated INHB relative to PT. INHB exhibited very high diagnostic accuracy for CPP [area under the curve (AUC) =0.82; 95% confidence interval (CI): 0.76-0.87; sensitivity 83.0%, specificity 62.7% at 21.95 pg/mL], surpassing AMH (AUC =0.58). Notably, AMH correlated inversely with gonadotropins (P<0.001). For distinguishing EFP from PT, INHB alone demonstrated high accuracy (AUC =0.894; 95% CI: 0.857-0.928; sensitivity 90.7%, specificity 76.8% at an optimal cutoff of 25.80 pg/mL). To avoid incorporation bias, UV was excluded from the primary predictive model; instead, the combination of INHB, AMH, and E2 achieved AUC =0.905 (95% CI: 0.867-0.938; sensitivity 80.4%, specificity 86.5%). INHB positively correlated with UV in EFP (ρ=0.26, P=0.009).
CONCLUSIONS: INHB is a useful diagnostic biomarker for CPP, while AMH helps differentiate CPP from PT. The INHB + AMH + E2 panel, which avoids UV to eliminate incorporation bias, shows high accuracy (AUC =0.905) for EFP detection and may assist clinical risk stratification.
METHODS: This retrospective cross-sectional study analyzed 423 girls [CPP: n=141; EFP: n=97; premature thelarche (PT): n=116; healthy controls: n=69] from Jiangxi Provincial Children's Hospital [2020-2022]. Clinical parameters, hormone levels (AMH, INHB, gonadotropins), uterine volume (UV), and ovarian volume (OV) were assessed. Diagnostic accuracy was evaluated via receiver operating characteristic (ROC) curves; biomarker relationships were examined using Spearman correlation.
RESULTS: Significant differences emerged across groups: CPP patients demonstrated lower AMH vs. PT (1.79 vs. 4.97 ng/mL, P<0.001) but higher INHB (32.20 vs. 21.75 pg/mL, P<0.001), while EFP showed elevated INHB relative to PT. INHB exhibited very high diagnostic accuracy for CPP [area under the curve (AUC) =0.82; 95% confidence interval (CI): 0.76-0.87; sensitivity 83.0%, specificity 62.7% at 21.95 pg/mL], surpassing AMH (AUC =0.58). Notably, AMH correlated inversely with gonadotropins (P<0.001). For distinguishing EFP from PT, INHB alone demonstrated high accuracy (AUC =0.894; 95% CI: 0.857-0.928; sensitivity 90.7%, specificity 76.8% at an optimal cutoff of 25.80 pg/mL). To avoid incorporation bias, UV was excluded from the primary predictive model; instead, the combination of INHB, AMH, and E2 achieved AUC =0.905 (95% CI: 0.867-0.938; sensitivity 80.4%, specificity 86.5%). INHB positively correlated with UV in EFP (ρ=0.26, P=0.009).
CONCLUSIONS: INHB is a useful diagnostic biomarker for CPP, while AMH helps differentiate CPP from PT. The INHB + AMH + E2 panel, which avoids UV to eliminate incorporation bias, shows high accuracy (AUC =0.905) for EFP detection and may assist clinical risk stratification.