Open AccessKisspeptin Levels in Girls with Precocious Puberty: A Systematic Review and Meta-Analysis
Author(s) -
Rafael Guerra Cintra,
Rubens Wajnsztejn,
Camila Martins Trevisan,
Victor Zaia,
Antonio Simone Laganà,
Bianca Bianco,
Erik Montagna
Publication year - 2020
Publication title -
hormone research in paediatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.816
H-Index - 89
eISSN - 1663-2826
pISSN - 1663-2818
DOI - 10.1159/000515660
Subject(s) - medicine , kisspeptin , meta analysis , precocious puberty , gonadotropin releasing hormone , endocrinology , central precocious puberty , gonadotropin , hormone , luteinizing hormone
Background/Aims: Kisspeptin (KP) is a key player in the regulation of the release of gonadotropin-releasing hormone (GnRH), which increases the secretion of gonadotropin during puberty to establish reproductive function and regulate the hypothalamic-pituitary-gonadal axis. Premature activation of GnRH secretion leads to idiopathic/central gonadotropin-dependent precocious puberty (CPP). We aimed to compare the blood KP concentrations in girls with CPP and healthy controls. Methods: A systematic review and meta-analysis was performed. We searched MEDLINE, EMBASE, The Cochrane Library, and SciELO. Random-effects model and standardized mean difference (SMD) were used. Heterogeneity was assessed through I 2 . Meta-regression considered patient age, KP fraction, and analytical method for KP measurement. Results: The 11 studies included comprised 316 CPP patients and 251 controls. Higher KP levels in the CPP group were found (SMD 1.53; CI 95% = 0.56–2.51). Subgroup analysis revealed association with patient age ( p = 0.048), indicating a positive correlation between elevation in KP concentration and age in CPP group. A group of patients with precocious thelarche (PT) from 5 of the included studies comprising 121 patients showed higher levels of KP (1.10; −0.25–2.45: CI 95%) and high heterogeneity ( I 2 = 91%). The CPP/PT ratio for KP level indicates KP 36% higher on CPP than PT patients. Conclusions: A consistent difference in KP levels between girls with CPP and controls was identified. While there are important limitations in KP assays which argue against its use as a diagnostic tool, the KP levels in CPP versus control and PT children are consistent with the predicted mechanisms and pathophysiology of CPP.