{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T10:10:04Z","timestamp":1780395004070,"version":"3.54.1"},"reference-count":17,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100015028","name":"Kangdong Sacred Heart Hospital, Hallym University","doi-asserted-by":"publisher","award":["2024-06"],"award-info":[{"award-number":["2024-06"]}],"id":[{"id":"10.13039\/501100015028","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpem-2025-0456_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\u03b1-Klotho is an anti-aging protein involved in insulin-like growth factor 1 (IGF-1) signaling and reproductive function. Studies in girls with central precocious puberty (CPP) reported elevated \u03b1-Klotho levels that declined with treatment, suggesting a potential biomarker role. Whether boys with CPP exhibit similar patterns remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0456_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included 36 boys with CPP and 34\u00a0age-matched healthy controls. \u03b1-Klotho, gonadotropins, testosterone, IGF-1, and other biochemical parameters were measured at baseline. In 15 patients, measurements were repeated after 6\u00a0months of gonadotropin-releasing hormone (GnRH) agonist therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0456_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Boys with CPP showed advanced bone age, higher body mass index standard deviation score (SDS), and elevated luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and IGF-1 SDS compared with controls. Baseline \u03b1-Klotho levels did not differ. Serum \u03b1-Klotho correlated strongly with testosterone (r=0.755, p&lt;0.001) and moderately with IGF-1 SDS (r=0.570, p&lt;0.001), but not with gonadotropins. In multiple regression, testosterone (\u03b2=0.612, p=0.004) and IGF-1 SDS (\u03b2=0.317, p=0.033) were independent predictors of \u03b1-Klotho. After 6\u00a0months of GnRH agonist therapy, testosterone and gonadotropins decreased significantly, while \u03b1-Klotho showed a non-significant decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0456_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Unlike girls with CPP, boys did not show elevated or treatment-responsive \u03b1-Klotho levels. The correlation with testosterone suggests \u03b1-Klotho may reflect androgenic activity in boys rather than serve as a dynamic biomarker. These findings should be considered exploratory, and larger studies with longer follow-up are needed to clarify its role in puberty and potential sex-specific regulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpem-2025-0456","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T22:28:56Z","timestamp":1762813736000},"page":"16-20","source":"Crossref","is-referenced-by-count":1,"title":["Serum \u03b1-Klotho and its association with testosterone in boys with central precocious puberty"],"prefix":"10.1515","volume":"39","author":[{"given":"Eu-seon","family":"Noh","sequence":"first","affiliation":[{"name":"Department of Pediatrics , Kangdong Sacred Heart Hospital , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Young","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Kangdong Sacred Heart Hospital , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Il Tae","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Kangdong Sacred Heart Hospital , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"2026010809595747791_j_jpem-2025-0456_ref_001","unstructured":"Chirico, V, Lacquaniti, A, Salpietro, V, Buemi, M, Salpietro, C, Arrigo, T. Central precocious puberty: from physiopathological mechanisms to treatment. J\u00a0Biol Regul Homeost Agents 2014;28:367\u201375."},{"key":"2026010809595747791_j_jpem-2025-0456_ref_002","doi-asserted-by":"crossref","unstructured":"Chen, M, Eugster, EA. Central precocious puberty: update on diagnosis and treatment. Paediatr Drugs 2015;17:273\u201381. https:\/\/doi.org\/10.1007\/s40272-015-0130-8.","DOI":"10.1007\/s40272-015-0130-8"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_003","doi-asserted-by":"crossref","unstructured":"Kim, YJ, Hwangbo, J, Park, KH, Kang, E, Nam, HK, Rhie, YJ, et al.. Effectiveness of the triptorelin stimulation test compared with the classic gonadotropin-releasing hormone stimulation test in diagnosing central precocious puberty in girls. Ann Pediatr Endocrinol Metab 2024;29:90\u20134. https:\/\/doi.org\/10.6065\/apem.2346054.027.","DOI":"10.6065\/apem.2346054.027"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_004","unstructured":"Krysiak, R, Szkr\u00f3bka, W, Kowalska, B, Okopie\u0144, B. Precocious puberty in boys. Przegl Lek 2014;71:549\u201358."},{"key":"2026010809595747791_j_jpem-2025-0456_ref_005","doi-asserted-by":"crossref","unstructured":"Yoon, JS, So, CH, Lee, HS, Lim, JS, Hwang, JS. The prevalence of brain abnormalities in boys with central precocious puberty may be overestimated. PLoS One 2018;13:e0195209. https:\/\/doi.org\/10.1371\/journal.pone.0195209.","DOI":"10.1371\/journal.pone.0195209"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_006","doi-asserted-by":"crossref","unstructured":"Soriano-Guill\u00e9n, L, Argente, J. Central precocious puberty, functional and tumor-related. Best Pract Res Clin Endocrinol Metab 2019;33:101262. https:\/\/doi.org\/10.1016\/j.beem.2019.01.003.","DOI":"10.1016\/j.beem.2019.01.003"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_007","doi-asserted-by":"crossref","unstructured":"Yaisilp, P, Numsriskulrat, N, Sahakitrungruang, T. Clinical and epidemiological insights into early puberty in Thai girls: a 5-year study. Ann Pediatr Endocrinol Metab 2025;30:17\u201324. https:\/\/doi.org\/10.6065\/apem.2448112.056.","DOI":"10.6065\/apem.2448112.056"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_008","doi-asserted-by":"crossref","unstructured":"Olauson, H, Mencke, R, Hillebrands, JL, Larsson, TE. Tissue expression and source of circulating \u03b1Klotho. Bone 2017;100:19\u201335. https:\/\/doi.org\/10.1016\/j.bone.2017.03.043.","DOI":"10.1016\/j.bone.2017.03.043"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_009","doi-asserted-by":"crossref","unstructured":"Dalton, GD, Xie, J, An, SW, Huang, CL. New insights into the mechanism of action of soluble klotho. Front Endocrinol (Lausanne) 2017;8:323. https:\/\/doi.org\/10.3389\/fendo.2017.00323.","DOI":"10.3389\/fendo.2017.00323"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_010","doi-asserted-by":"crossref","unstructured":"Buchanan, S, Combet, E, Stenvinkel, P, Shiels, PG. Klotho, aging, and the failing kidney. Front Endocrinol (Lausanne) 2020;11:560. https:\/\/doi.org\/10.3389\/fendo.2020.00560.","DOI":"10.3389\/fendo.2020.00560"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_011","doi-asserted-by":"crossref","unstructured":"Xie, T, Ye, W, Liu, J, Zhou, L, Song, Y. The emerging key role of klotho in the hypothalamus-pituitary-ovarian axis. Reprod Sci 2021;28:322\u201331. https:\/\/doi.org\/10.1007\/s43032-020-00277-5.","DOI":"10.1007\/s43032-020-00277-5"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_012","doi-asserted-by":"crossref","unstructured":"Park, JH, Noh, ES, Hwang, IT. alpha-Klotho levels in girls with central precocious puberty: potential as a diagnostic and monitoring marker. Front Endocrinol (Lausanne) 2024;15:1383812. https:\/\/doi.org\/10.3389\/fendo.2024.1383812.","DOI":"10.3389\/fendo.2024.1383812"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_013","doi-asserted-by":"crossref","unstructured":"Glover, F, Sullivan, E, Mulloy, E, Belladelli, F, Del Giudice, F, Eisenberg, ML. The relationship between klotho, testosterone, and sexual health parameters among US adult men. J\u00a0Endocrinol Investig 2024;47:523\u201333. https:\/\/doi.org\/10.1007\/s40618-023-02163-8.","DOI":"10.1007\/s40618-023-02163-8"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_014","doi-asserted-by":"crossref","unstructured":"Hsu, SC, Huang, SM, Lin, SH, Ka, SM, Chen, A, Shih, MF, et al.. Testosterone increases renal anti-aging klotho gene expression via the androgen receptor-mediated pathway. Biochem J 2014;464:221\u20139. https:\/\/doi.org\/10.1042\/bj20140739.","DOI":"10.1042\/BJ20140739"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_015","doi-asserted-by":"crossref","unstructured":"Gkentzi, D, Efthymiadou, A, Kritikou, D, Chrysis, D. Fibroblast growth factor 23 and Klotho serum levels in healthy children. Bone 2014;66:8\u201314. https:\/\/doi.org\/10.1016\/j.bone.2014.05.012.","DOI":"10.1016\/j.bone.2014.05.012"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_016","doi-asserted-by":"crossref","unstructured":"Socha-Banasiak, A, Michalak, A, Paczes, K, Gaj, Z, Fendler, W, Socha, A, et al.. Klotho and fibroblast growth factors 19 and 21 serum concentrations in children and adolescents with normal body weight and obesity and their associations with metabolic parameters. BMC Pediatr 2020;20:294. https:\/\/doi.org\/10.1186\/s12887-020-02199-2.","DOI":"10.1186\/s12887-020-02199-2"},{"key":"2026010809595747791_j_jpem-2025-0456_ref_017","doi-asserted-by":"crossref","unstructured":"Carreras-Badosa, G, Puerto-Carranza, E, Mas-Pares, B, Gomez-Vilarrubla, A, Gomez-Herrera, B, Diaz-Roldan, F, et al.. Higher levels of serum alpha-Klotho are longitudinally associated with less central obesity in girls experiencing weight gain. 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