Study Details Differences in Diagnosis, Characteristics of Precocious Puberty During Pandemic

Yao Chen, PhD

Data from a recent study from Shanghai details differences in the diagnosis rates and clinical features of girls with precocious puberty before and during the COVID-19 pandemic.

A cross-sectional study of data collected from precious girls between 2016 and 2020 from Shanghai Children’s Medical Center, results of the study suggest monthly incidence rates of precocious puberty increased during the pandemic compared to pre-pandemic periods and also provide insight into the decreased concentrations of serum MKRN3 and ghrelin observed among the study population.

“In the present study, we found that the incidence rates of precocious puberty were increased and concentrations of serum MKRN3 and ghrelin were decreased during the COVID-19 pandemic among Shanghai school-aged girls,” wrote investigators.

As the COVID-19 pandemic continues beyond the 2-year mark in most, if not all, corners of the globe, reports of an increased rate of diagnoses for precocious puberty have begun to accumulate. Citing an interest in investigating the increased prevalence of precocious puberty during the pandemic, Yao Chen, PhD, MS, a postdoctoral research fellow, and a team of colleagues from Shanghai Jiao Tong University sought to evaluate these potential differences among children presenting to the university-affiliated children’s hospital.

Designed as a cross-sectional study, investigators used data from precocious girls who received care at the Shanghai Children’s Medical Center from March to August from 2016-2019 and 2020. From these time periods, investigators identified cohorts of 246 and 237 precocious girls, respectively, for inclusion in their analyses. After exclusion of those with abnormal brain and pituitary gland MRI reports, another endocrine disease, or chronic diseases, 209 girls were included in the 2016-2019 group and 191 were included in the 2020 pandemic group.

The primary outcomes of interest for the investigators’ analyses was to compare the incidence rates and clinical features of those receiving care before and during the COVID-19 pandemic. For the purpose of analysis, investigators used linear regression models to assess associations between biomarkers and potential mechanisms contributing to potential increases in monthly incidence rates and clinical features.

Upon analysis, investigators found the monthly incidence rates of precocious puberty in outpatient girls from March-December 2020 (0.44-1.36%) and among inpatient girls from March-August 2020 (27.04-47.83%) were higher than those in 2016-2019. (0.30-0.52% and 10.53-18.42%, respectively). Further analysis indicated those in the 2020 group had greater serum concentrations of GnRH than those in the 2016-2019 group (2.81 vs 1.99 mg/L) but serum concentrations of MKRN3 (1.02 vs 1.93 ng/ml) and ghrelin (0.38 vs 0.88 ng/ml) were lower in the 2020 group compared to the 2016-2019 group. Investigators also pointed out their results suggested serum concentration of ghrelin was positively associated with the serum concentration of MKRN3 (β=0.891 [95% CI, 0.612-1.171]; P <.001).

“Compared with data from 2016-2019 years, the monthly incidence of precocious puberty among Shanghai school-aged girls was increased in 2020. Furthermore, a positive correlation between serum concentrations of ghrelin and MKRN3 was found, which indicated ghrelin as a potential regulatory mechanism of puberty. Longitudinal studies are needed to determine the causal relationship between ghrelin and MKRN3,” investigators wrote.

This study, “Difference of Precocious Puberty Between Before and During the COVID-19 Pandemic: A Cross-Sectional Study Among Shanghai School-Aged Girls,” was published in Frontiers in Endocrinology.