進行が緩徐な中枢性思春期早発症 vs. 進行が急速な中枢性思春期早発症の比較分析：単一施設経験

Central precocious puberty (CPP) can present as either slowly progressing CPP (SP-CPP) or rapidly progressing CPP (RP-CPP). The speed of progression is critical in determining treatment decisions. This study aims to compare the clinical data between patients who received treatment and those who did not, and to identify factors that may influence the progression in cases of RP-CPP.

This single-center retrospective observational study includes 406 female patients aged 5-8 years who were followed for CPP at the pediatric endocrinology clinic between 2021 and 2023. The patients were categorized into two groups: those with SP-CPP who did not receive gonadotropin-releasing hormone agonist (GnRHa) treatment (n=252) and those with RP-CPP who did receive GnRHa treatment (n=154). Patients were analyzed according to clinical, laboratory, and radiological findings.

The median age at onset of pubertal signs were 7.2 years (Range 5-8) for the SP-CPP group and 7 (5-8) years for the RP-CPP group (p=0.352). In univariate analysis, Tanner breast stage, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, peak LH levels, and bone age/chronological age ratios were significantly higher in the RP-CPP group. In multivariate logistic regression analysis, Tanner breast stage (p=0.001) and the bone age/chronological age ratio (p<0.001) were found to be a significant parameter, while other variables were not significant (p>0.05).

In this cohort, the bone age/chronological age ratio is a significant parameter for early detection of rapidly progressing precocious puberty cases. It is crucial to classify early puberty cases by evaluating clinical, laboratory, and radiological findings collectively and to make treatment decisions based on individual assessments.