A kisspeptin-10/basal LH ratio distinguished girls with central precocious puberty from girls with premature thelarche with 78% accuracy, whereas kisspeptin-10 alone did not. The result comes from a prospective study of Indian girls aged 6-9 years and suggests this ratio might reduce the need for GnRH stimulation testing.
Journal article — prospective diagnostic accuracy study. Population: Indian girls aged 6-9 years with ICPP, PT, or healthy controls. Sample size: 40 controls, 33 ICPP, 23 PT.
Kp-10 and NKB were higher in both early-puberty groups than controls, but neither marker alone discriminated ICPP from PT. The Kp-10/basal LH ratio at a cut-off <4.07 ng/mIU had sensitivity 72.7%, specificity 87.0%, and accuracy 78%. All three logistic models showed similar discrimination (AUC 0.78-0.79), and adding bone age advancement or estradiol did not meaningfully improve prediction. Decision curve analysis showed a higher net benefit for the ratio than treat-all or treat-none strategies. Anthropometric parameters did not differ between ICPP and PT.
This paper matters for kisspeptin researchers because it evaluates Kp-10 as a clinically accessible diagnostic marker and shows its value only when combined with basal LH. It does not demonstrate that Kp-10 alone distinguishes precocious puberty from premature thelarche, nor does it establish a causal role for kisspeptin or validate the ratio in other populations.
Peptide profiles: Kisspeptin.
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