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Nguyen NN, Huynh LBP, Do MD, et al. Diagnostic Accuracy of Female Pelvic Ultrasonography in Differentiating Precocious Puberty From Premature Thelarche: A Systematic Review and Meta-analysis. Front Endocrinol (Lausanne). 2021;12:735875doi: 10.3389/fendo.2021.735875.
Nguyen, N. N., Huynh, L. B. P., Do, M. D., Yang, T. Y., Tsai, M. C., & Chen, Y. C. (2021). Diagnostic Accuracy of Female Pelvic Ultrasonography in Differentiating Precocious Puberty From Premature Thelarche: A Systematic Review and Meta-analysis. Frontiers in endocrinology, 12735875. https://doi.org/10.3389/fendo.2021.735875
Nguyen, Nam Nhat, et al. "Diagnostic Accuracy of Female Pelvic Ultrasonography in Differentiating Precocious Puberty From Premature Thelarche: A Systematic Review and Meta-analysis." Frontiers in endocrinology vol. 12 (2021): 735875. doi: https://doi.org/10.3389/fendo.2021.735875
Nguyen NN, Huynh LBP, Do MD, Yang TY, Tsai MC, Chen YC. Diagnostic Accuracy of Female Pelvic Ultrasonography in Differentiating Precocious Puberty From Premature Thelarche: A Systematic Review and Meta-analysis. Front Endocrinol (Lausanne). 2021 Sep 01;12:735875. doi: 10.3389/fendo.2021.735875. eCollection 2021. PMID: 34539579; PMCID: PMC8442957.
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Front Endocrinol (Lausanne). 2021 Sep 01;12:735875. doi: 10.3389/fendo.2021.735875. eCollection 2021.

Diagnostic Accuracy of Female Pelvic Ultrasonography in Differentiating Precocious Puberty From Premature Thelarche: A Systematic Review and Meta-analysis.

Frontiers in endocrinology

Nam Nhat Nguyen, Linh Ba Phuong Huynh, Minh Duc Do, Tien Yun Yang, Meng-Che Tsai, Yang-Ching Chen

Affiliations

  1. International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  2. Ph.D. Program in School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.
  3. Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
  4. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  5. Division of Genetics, Endocrinology, and Metabolism, Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
  6. College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  7. Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
  8. Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

PMID: 34539579 PMCID: PMC8442957 DOI: 10.3389/fendo.2021.735875

Abstract

BACKGROUND: The gonadotropin-releasing hormone (GnRH) stimulation test is the benchmark for diagnosing precocious puberty (PP). However, it is invasive, time-consuming, costly, and may create an unpleasant experience for participants. Moreover, some overlaps may occur between PP and premature thelarche (PT) in the early stage of PP. Female pelvic ultrasonography may provide additional information to help differentiate PP from PT and subsequently initiate early treatment. In this study, we aimed to first directly compare pelvic ultrasonography parameters between PP and PT groups and secondly, investigate their diagnostic accuracy compared with the GnRH stimulation test.

METHODS: A systematic search of the PubMed/MEDLINE, EMBASE, Scopus, and Cochrane Library databases was performed up to March 31, 2021. All types of studies, except for case reports and review articles, were included. The GnRH stimulation test was used to confirm PP diagnosis. Those whose organic conditions might cause PP were excluded. The mean, standard deviation, sensitivity, and specificity of each parameter were documented. Forest plots were constructed to display the estimated standardized mean differences (SMDs) from each included study and the overall calculations. A bivariate model was used to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR).

RESULTS: A total of 13 studies were included for analysis. The SMDs (95% confidence interval - CI) in ovarian volume, fundal-cervical ratio, uterine length, uterine cross-sectional area, and uterine volume between PP and PT groups were 1.12 (0.78-1.45; p < 0.01), 0.90 (0.07-1.73; p = 0.03), 1.38 (0.99-1.78; p < 0.01), 1.06 (0.61-1.50; p < 0.01), and 1.21 (0.84-1.58; p <0.01), respectively. A uterine length of 3.20 cm yielded a pooled sensitivity of 81.8% (95% CI 78.3%-84.9%), specificity of 82.0% (95% CI 61.0%-93.0%), PLR of 4.56 (95% CI 2.15-9.69), NLR of 0.26 (95% CI 0.17-0.39), and DOR of 19.62 (95% CI 6.45-59.68). The area under the summary receiver operating characteristics curve was 0.82.

CONCLUSION: Female pelvic ultrasonography may serve as a complementary tool to the GnRH stimulation test in differentiating PP from PT.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232427, ID: CRD42021232427.

Copyright © 2021 Nguyen, Huynh, Do, Yang, Tsai and Chen.

Keywords: diagnostic accuracy; pelvic ultrasonography; precocious puberty; premature thelarche; uterine length

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

  1. J Pediatr Endocrinol Metab. 2014 Nov;27(11-12):1193-9 - PubMed
  2. Korean J Pediatr. 2015 Aug;58(8):294-300 - PubMed
  3. Sci Rep. 2015 Jun 18;5:11208 - PubMed
  4. Ultrasound Obstet Gynecol. 2008 Nov;32(6):819-27 - PubMed
  5. Ann Intern Med. 2011 Oct 18;155(8):529-36 - PubMed
  6. J Pediatr. 1995 Jan;126(1):11-4 - PubMed
  7. Lancet Oncol. 2012 Nov;13(11):1141-51 - PubMed
  8. Diabetologia. 2020 Jun;63(6):1141-1150 - PubMed
  9. J Clin Endocrinol Metab. 1988 Sep;67(3):474-9 - PubMed
  10. AJR Am J Roentgenol. 2002 Jun;178(6):1531-6 - PubMed
  11. BMC Med Res Methodol. 2016 Aug 12;16(1):97 - PubMed
  12. Eur J Pediatr. 1995 Mar;154(3):182-6 - PubMed
  13. Ultrasound Obstet Gynecol. 2003 Sep;22(3):277-83 - PubMed
  14. J Clin Endocrinol Metab. 2014 Feb;99(2):433-9 - PubMed
  15. J Clin Epidemiol. 2005 Sep;58(9):882-93 - PubMed
  16. Arch Dis Child. 1985 Feb;60(2):120-5 - PubMed
  17. J Clin Res Pediatr Endocrinol. 2012 Dec;4(4):208-12 - PubMed
  18. J Ultrasound Med. 2002 Nov;21(11):1237-46; quiz 1247-8 - PubMed
  19. Cancer. 1950 Jan;3(1):32-5 - PubMed
  20. Pediatr Radiol. 1994;24(1):11-3 - PubMed
  21. J Hypertens. 2006 Jan;24(1):59-66 - PubMed
  22. J Clin Endocrinol Metab. 1995 Feb;80(2):546-51 - PubMed
  23. Int J Epidemiol. 2009 Feb;38(1):245-52 - PubMed
  24. Eur J Endocrinol. 2006 Jun;154(6):891-8 - PubMed
  25. Acta Paediatr. 1998 Nov;87(11):1138-45 - PubMed
  26. J Int Med Res. 2020 Aug;48(8):300060520935278 - PubMed
  27. J Clin Ultrasound. 2013 Feb;41(2):84-93 - PubMed
  28. Pediatrics. 2009 Apr;123(4):e752-62 - PubMed
  29. Arch Dis Child. 1998 Aug;79(2):173-4 - PubMed
  30. J Pediatr. 2019 May;208:221-228 - PubMed

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