{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:02:51Z","timestamp":1791576171213,"version":"4.3.4"},"reference-count":76,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Distinguishing central precocious or early puberty (CPP\/EP) from nonprogressive premature breast development (npPBD) is challenging, particularly in the context of increasing childhood adiposity, which may affect growth and skeletal maturation independently of hypothalamic-pituitary-ovarian (HPO) axis activation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively evaluated 100 girls (69 CPP\/EP, 31 npPBD) and 16 age-matched prepubertal girls with obesity as controls. Assessments included auxology, bone age, hormonal and metabolic profiles, pelvic ultrasound, DXA-derived body composition, and lifestyle factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Anthropometric parameters and bone age were similar between CPP\/EP and npPBD, whereas LH, FSH, estradiol, and IGF-1 SDS (all P &amp;lt; .001) remained the main discriminators between groups. Overall body composition was comparable, except for a higher android-to-gynoid fat ratio in npPBD (P = .03). In both diagnostic groups, overweight\/obesity was associated with greater height relative to target height (P = .004 in CPP\/EP; P = .03 in npPBD) and higher IGF-1 SDS (P &amp;lt; .001 and P = .02, respectively) compared with controls. Among normal-weight girls, those with CPP\/EP showed greater height relative to target height (P = .009) and more advanced bone age (P = .02) than those with npPBD, whereas these differences were not observed in girls with overweight\/obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Excess adiposity reduces the diagnostic specificity of auxological and skeletal maturation parameters in girls with early breast development. Biochemical assessment remains central, with IGF-1 SDS providing additional supportive information.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jendso\/bvag134","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T11:43:10Z","timestamp":1781782990000},"source":"Crossref","is-referenced-by-count":1,"title":["Distinguishing central precocious puberty from nonprogressive breast development: adiposity and DXA body composition"],"prefix":"10.1210","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0128-6501","authenticated-orcid":false,"given":"Daniela","family":"Fava","sequence":"first","affiliation":[{"name":"Pediatric Endocrinology Unit, Department of Pediatrics, IRCCS Istituto Giannina Gaslini , Genoa 16147 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6005-5068","authenticated-orcid":false,"given":"Amanda","family":"Casirati","sequence":"additional","affiliation":[{"name":"Pediatric Endocrinology Unit, Department of Pediatrics, IRCCS Istituto Giannina Gaslini , Genoa 16147 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6246-9299","authenticated-orcid":false,"given":"Maria Grazia","family":"Calevo","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics Unit, Scientific Directorate, IRCCS Istituto Giannina Gaslini , Genoa 16147 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Angelelli","sequence":"additional","affiliation":[{"name":"Pediatric Endocrinology Unit, Department of Pediatrics, IRCCS Istituto Giannina Gaslini , Genoa 16147 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Maria","family":"Allegri","sequence":"additional","affiliation":[{"name":"Pediatric Endocrinology Unit, Department of Pediatrics, IRCCS Istituto Giannina Gaslini , Genoa 16147 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppa","family":"Patti","sequence":"additional","affiliation":[{"name":"Pediatric Endocrinology Unit, Department of Pediatrics, IRCCS Istituto Giannina Gaslini , Genoa 16147 ,","place":["Italy"]},{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa , Genoa 16132 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Naim","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa , Genoa 16132 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