用于监测中枢性性早熟女孩治疗的 Kisspeptin 和 DLK1 水平。

IF 3.2 Q1 PEDIATRICS Clinical and Experimental Pediatrics Pub Date : 2024-06-01 Epub Date: 2024-05-21 DOI:10.3345/cep.2023.01361

Witchuwan Onsoi, Nattakarn Numsriskulrat, Suphab Aroonparkmongkol, Vichit Supornsilchai, Khomsak Srilanchakon

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引用次数: 0

摘要

背景：据报道，Kisspeptin和delta-like 1同源物（DLK1）分别通过激活和抑制下丘脑-垂体-性腺轴，在青春期时间上发挥重要作用。因此，血清中的吻肽（kisspeptin）和DLK1水平可能是区分女孩中枢性性早熟（CPP）和早熟（PT）的新型生物标志物，并可用于监测CPP的治疗情况。目的：比较CPP女孩在诊断时和治疗后的血清吻肽（kisspeptin）和DLK1基线水平，以及PT女孩与年龄匹配者的血清吻肽（kisspeptin）和DLK1水平：这项前瞻性纵向研究纳入了8岁前乳房发育且黄体生成素峰值水平≥6的性早熟女孩和PT女孩：研究将 48 名女孩分为 CPP 组（24 人；平均年龄为 7.7±0.7 岁）和 PT 组（24 人；平均年龄为 7.4±0.8 岁）。基线中位血清Kisspeptin水平分别为50.5 pg/mL（范围：38.2-77 pg/mL）和49.5 pg/mL（范围：39.7-67.6 pg/mL）（P=0.89），而基线中位血清DLK1水平分别为6.5 ng/mL（范围：5.9-7.5 ng/mL）和6 ng/mL（4.4-14.4 ng/mL）（P=0.68）。CPP组患者在接受6个月的GnRH类似物治疗后，血清kisspeptin的中位水平（46.4 ng/mL；范围：37.1-60 ng/mL）低于基线水平（P=0.002），而血清DLK1的中位水平（7 ng/mL；范围：6.7-8.9）高于基线水平（P=0.002）：我们的研究结果表明，基线血清kisspeptin和DLK1水平并不是区分CPP和PT的可靠生物标志物。然而，血清吻肽和DLK1水平的明显变化可用于监测CPP的治疗。

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Kisspeptin and DLK1 levels for monitoring treatment of girls with central precocious puberty.

Background: Kisspeptin and delta-like 1 homolog (DLK1) are neuropeptides that reportedly play an important role in pubertal timing by activating and inhibiting the hypothalamic-pituitary-gonadal axis, respectively. Consequently, serum kisspeptin and DLK1 levels may be novel biomarkers for differentiating between central precocious puberty (CPP) and premature thelarche (PT) in girls and used to monitor CPP treatment.

Purpose: To compare baseline serum kisspeptin and DLK1 levels in girls with CPP at diagnosis and after treatment to age-matched girls with PT.

Methods: This prospective longitudinal study included girls with precocious puberty and girls with PT who experienced breast development before 8 years of age and peak luteinizing hormone levels of ≥6 versus <6 IU/L after a gonadotropin-releasing hormone (GnRH) stimulation test. Serum kisspeptin and DLK1 levels were determined in both groups at baseline and after 6 months of GnRH analog treatment in the CPP group and analyzed by enzyme-linked immunosorbent assay.

Results: The study divided a total of 48 girls into CPP (n=24; mean age, 7.7±0.7 years) and PT (n=24; mean age, 7.4±0.8 years) groups. The baseline median serum kisspeptin levels were 50.5 pg/mL (range, 38.2-77 pg/mL) and 49.5 pg/mL (range, 39.7-67.6 pg/mL), respectively (P=0.89), while the baseline median serum DLK1 levels were 6.5 ng/mL (range, 5.9-7.5 ng/mL) and 6 ng/mL (4.4-14.4 ng/mL), respectively (P=0.68). After 6 months of GnRH analog treatment in the CPP group, the median serum kisspeptin level was lower (46.4 ng/mL; range, 37.1-60 ng/mL) than that at baseline (P=0.002), while the median serum DLK1 level was higher (7 ng/mL; range, 6.7-8.9) than that at baseline (P=0.002).

Conclusion: Our findings suggest that baseline serum kisspeptin and DLK1 levels are not reliable biomarkers for differentiating between CPP and PT. However, significant changes in serum kisspeptin and DLK1 levels may be used to monitor CPP treatment.

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