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Correlation analysis of pituitary morphometry in boys with idiopathic central precocious puberty or early puberty:

Yi Song^1,2, Xi-Ou Wang², Wen-Quan Niu³

¹Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China.

Translational Pediatrics

|November 11, 2025

Insights

Idiopathic central precocious puberty (ICPP) and early puberty (EP) in boys are linked to increased pituitary gland size. Pituitary width and volume may serve as diagnostic imaging biomarkers for these conditions.

Area of Science:

Pediatric Endocrinology
Radiology
Biomarkers

Background:

Idiopathic central precocious puberty (ICPP) and early puberty (EP) impact male growth and development.
Brain MRI is used to rule out organic causes, but pituitary morphometry's diagnostic value in boys is understudied.
This study explores pituitary dimensions as potential imaging biomarkers.

Purpose of the Study:

Investigate associations between pituitary morphometry (length, width, height, volume) and ICPP/EP in boys.
Evaluate the potential of pituitary dimensions as diagnostic imaging biomarkers for ICPP/EP.
Determine if pituitary morphometry can aid in differentiating ICPP/EP from healthy development.

Main Methods:

Retrospective case-control study of 354 boys (118 with ICPP/EP, 236 controls).
Contrast-enhanced MRI used to measure pituitary dimensions and volume.
Statistical analyses included Spearman correlation and multivariable logistic regression with RCS.

Main Results:

Boys with ICPP/EP showed significantly greater pituitary width and volume than controls.
Pituitary width and volume correlated with luteinizing hormone (LH) and testicular volume in cases.
Pituitary width >13 mm or volume >240 mm³ indicated increased risk for ICPP/EP.

Conclusions:

Increased pituitary width and volume are associated with ICPP/EP in boys.
These morphometric measures correlate with hormonal and gonadal development markers.
Pituitary dimensions show promise as imaging biomarkers for diagnosing ICPP/EP in males.

Read full analysis

Abstract

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.

Keywords:

Idiopathic central precocious puberty (ICPP)boys early puberty (EP)magnetic resonance imaging (MRI)pituitary gland

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