A systematic review supporting the Endocrine Society clinical practice guidelines on central precocious puberty.

Background

To summarize the available supporting evidence for the Endocrine Society guidelines about the management of CPP.

总结内分泌学会关于CPP管理指南的现有支持证据。

Methods

Multiple databases (MEDLINE, EMBASE, Scopus) were searched to identify studies that addressed the Endocrine Society Guideline Development Panel's 10 clinical questions.

通过多个数据库（MEDLINE、EMBASE、Scopus）进行检索，以确定那些解决了内分泌学会指南制定小组的10个临床问题的研究。

Identified studies were selected and appraised, and data were extracted by pairs of independent trained reviewers.

选定的研究被挑选和评估，数据由独立的受过培训的评审员对进行提取。

Results

The systematic reviewyielded 3796 citations, of which 32 citations were included.

系统综述产生了3796条引文，其中32条引文被纳入。

The systematic reviewand meta-analysisdemonstrate that in children with CPP, with no central nervous system symptoms, the rate of magnetic resonance imaging identification of pathogenic lesions (ie, hamartomas and brain tumors) was 6% (35 noncomparative studies with 5541 children with CPP).

系统综述和荟萃分析显示，在没有中枢神经系统症状的儿童中，促性腺激素释放激素依赖性性早熟（CPP）患者的磁共振成像识别致病性病变（即错构瘤和脑肿瘤）的检出率为6%（35项非比较性研究，共5541名CPP儿童）。

For girls with idiopathic CPP, gonadotropin-releasing hormone agonist (GnRHa) treatment was associated with +2.7 cm adult height gain compared to those who did not receive treatment (21 comparative observational studies with 1835 girls [mean age 8.20 ± 1.08 years]).

对于特发性中枢性性早熟的女孩，促性腺激素释放激素激动剂（GnRHa）治疗与未接受治疗的女孩相比，成年身高增加了2.7厘米（1835名女孩的21项比较观察性研究[平均年龄8.20±1.08岁]）。

The review did not identify any studies that assessed the clinical questions on: benefits of additional evaluation in cases of early thelarche, differentiation of slowly vs rapidly progressing CPP, order of biochemical testing to establish and monitor the diagnosis of CPP, genetic testing for individuals diagnosed with CPP, and chronological age and/or bone age for discontinuation of GnRHa treatment.

综述没有发现任何研究评估了以下临床问题：早期乳房发育病例中额外评估的好处、缓慢进展与快速进展的中枢性性早熟的鉴别、用于建立和监测中枢性性早熟诊断的生化测试顺序、对确诊为中枢性性早熟的个体进行的基因测试，以及使用年龄和/或骨龄停止GnRHa治疗。

Conclusions

This systematic reviewaddresses various aspects of CPP evaluation and treatment of CPP and will support the development of the Endocrine Society guidelines.

本系统评价涉及儿童早熟性性征（CPP）评估和治疗的多个方面，并将支持内分泌学会指南的制定。