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 I². 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 (I² = 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.
Horm Res Paediatr

中文翻译：

---

性早熟女孩的 Kisspeptin 水平：系统评价和荟萃分析

背景/目的： Kisspeptin (KP) 是调节促性腺激素释放激素 (GnRH) 释放的关键参与者，其在青春期增加促性腺激素的分泌以建立生殖功能并调节下丘脑-垂体-性腺轴。GnRH 分泌的过早激活导致特发性/中枢性促性腺激素依赖性性早熟 (CPP)。我们旨在比较 CPP 和健康对照女孩的血液 KP 浓度。方法：进行了系统评价和荟萃分析。我们检索了 MEDLINE、EMBASE、Cochrane 图书馆和 SciELO。使用随机效应模型和标准化平均差 (SMD)。通过I ²评估异质性. 元回归考虑了患者年龄、KP 分数和 KP 测量的分析方法。结果：纳入的 11 项研究包括 316 名 CPP 患者和 251 名对照。发现 CPP 组的 KP 水平较高（SMD 1.53；CI 95% = 0.56–2.51）。亚组分析显示与患者年龄相关 ( p = 0.048)，表明 CPP 组中 KP 浓度升高与年龄之间呈正相关。包括 121 名患者在内的 5 项纳入研究中的一组早熟性乳糜泻 (PT) 患者表现出较高的 KP 水平 (1.10；-0.25–2.45：CI 95%) 和高异质性 ( I ² = 91%)。KP 水平的 CPP/PT 比率表明 CPP 的 KP 比 PT 患者高 36%。结论：确定了 CPP 女孩和对照组之间 KP 水平的一致差异。虽然 KP 检测存在重要限制，反对将其用作诊断工具，但 CPP 与对照和 PT 儿童的 KP 水平与 CPP 的预测机制和病理生理学一致。
儿科研究