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Predictive Modeling of Central Precocious Puberty Using IGF-1 and IGFBP-3 Standard Deviation Scores

Rihwa Choi1,2, Gayoung Chun3, Sung-Eun Cho4

  • 1Laboratory Medicine Center, Division of Laboratory Medicine, GC Labs, Yongin-si 16924, Republic of Korea.

Diagnostics (Basel, Switzerland)
|October 16, 2025
PubMed

Insights

Baseline insulin-like growth factor 1 (IGF-1) and IGF-binding protein 3 (IGFBP-3) standard deviation scores (SDS) improve central precocious puberty (CPP) diagnosis in predictive models for Korean children. Sex-specific interpretation is crucial for accurate clinical application.

Area of Science:

  • Pediatric Endocrinology
  • Reproductive Medicine
  • Clinical Diagnostics

Background:

  • Central precocious puberty (CPP) diagnosis relies on gonadotropin-releasing hormone (GnRH) stimulation testing, which is often burdensome for pediatric patients.
  • Evaluating baseline hormonal markers can offer a less invasive diagnostic approach.

Purpose of the Study:

  • To assess the utility of baseline hormonal markers, specifically insulin-like growth factor 1 (IGF-1) and IGF-binding protein 3 (IGFBP-3), as auxiliary tools for diagnosing CPP in Korean children.
  • To determine the diagnostic accuracy of these markers, alone and in predictive models, using standard deviation scores (SDS).

Main Methods:

  • Retrospective analysis of 2464 Korean children who underwent GnRH stimulation testing.
  • Assessment of baseline luteinizing hormone (LH), follicle-stimulating hormone (FSH), IGF-1, and IGFBP-3 levels, with SDS calculation using two reference intervals.
  • Multivariable logistic regression and receiver operating characteristic (ROC) analyses, stratified by sex, to evaluate diagnostic performance (Area Under Curve - AUC).

Main Results:

  • Follicle-stimulating hormone (FSH) demonstrated the highest AUCs among individual baseline markers (0.767 in girls, 0.895 in boys).
  • Predictive models incorporating IGF-1 SDS and IGFBP-3 SDS significantly improved diagnostic performance (AUC = 0.800 in girls, 0.920 in boys) compared to using these markers alone.
  • Central precocious puberty prevalence was 54.2% in girls and 65.6% in boys.

Conclusions:

  • Standard deviation scores (SDS) of IGF-1 and IGFBP-3 enhance the diagnostic accuracy of central precocious puberty (CPP) when integrated into predictive models.
  • The findings underscore the importance of sex-specific interpretation and standardized reference intervals for these markers in clinical practice.
  • This approach may reduce the reliance on burdensome GnRH stimulation testing.

Keywords:
central precocious pubertyfollicle-stimulating hormoneinsulin-like growth factor Iinsulin-like growth factor-binding protein 3luteinizing hormonestandard deviation scores

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