Early diagnostic value of serum IGF-1, FGF23 and Klotho in girls with rapidly progressive central precocious puberty

Purpose: This study explored the early warning value of serum insulin-like growth factor-1(IGF-1), fibroblast growth factor 23(FGF23), and Klotho levels in girls with rapidly progressive central precocious puberty (RP-CPP). Method: This is a prospective cohort study on the progression rate of central precocious puberty in girls, who complained of breast development before the age of 8 years and were followed between June 2021and June 2022. At the same time, 28 healthy girls less than 8 years old who had not started puberty were recruited as the control group. The physical examination and laboratory evaluation of each group was completed. Only patients with CPP received pelvic ultrasound examination and bone age test. The ROC curve was used to judge the warning value. Results: Bone age index (BAI), basal LH levels (BLH), basal LH levels / basal FSH levels (BFSH), peak LH (PLH) / peak FSH (PFSH), IGF-1, Klotho, FGF23 and ovarian volume in RP-CPP group were higher than those in slowly progressive CPP (SP-CPP) group. In the RP-CPP group, IGF-1 was correlated with Klotho, FGF23, and BLH; Klotho was correlated with FGF23 and BLH; FGF23 was correlated with BLH. The AUC of BLH, Klotho, and IGF-1 were 0.931,0.829 and 0.809, respectively. The AUC was the largest when BLH and Klotho were combined. Conclusions: The BLH, Klotho, and IGF-1 have early warning effects on RP-CPP. The binding analysis improves the effectiveness of diagnosis.