Fibroblast growth factor 21 and its relationship with central precocious puberty in girls

Studies have shown that obesity and insulin resistance are associated with central precocious puberty (CPP) in girls. Serum fibroblast growth factor 21 (FGF21) levels are associated with obesity and insulin resistance and are also related to ovarian development, reproductive function, and gonadotropin-releasing hormone (GnRH) neuron development. The aim of this study was to investigate the levels of serum FGF21 in girls with CPP.

This study enrolled 106 girls aged 6-10 years who were evaluated at the hospital's Growth and Development Clinic. The cohort comprised 55 girls diagnosed with CPP as the case group and 51 age-matched girls with normal growth and development as the control group. Data including age, age at onset of puberty or menarche, anthropometric measurements, IGF1 levels, bone age (BA), ovarian and uterine development, hormone profiles, β-Klotho levels, and FGF21 levels were collected and statistically analyzed.

Bone age advancement, IGF1, β-Klotho, and FGF21 levels showed statistically significant differences between the CPP and control groups. FGF21 and β-Klotho levels were negatively associated with CPP, with areas under the ROC curve of 0.833 and 0.770, respectively. The optimal cut-off values were 156.28 pg/mL and 7,057.18 pg/mL for β-Klotho. In girls with CPP, the FGF21 levels were weakly positively correlated with the β-Klotho levels (r = 0.273).

Compared with age-matched girls without pubertal initiation, girls diagnosed with CPP had significantly lower serum levels of FGF21 and β-Klotho, suggesting that FGF21 may be involved in the regulation of pubertal onset. However, the underlying molecular mechanisms require further investigation.