The first report about the prevalence of precocious puberty that was based on nationwide data was from Denmark in 2005, and the estimate of precocious puberty incidence in girls younger than 9 years was 200 per 100,000 person years and it was 50 per 100,000 person years in boys who were younger than 10 years. This is the first epidemiologic study utilizing a large-scale national registry that has explored the prevalence and incidence of CPP in Asia.įew reports have described the prevalence of precocious puberty. Furthermore, from 2004 to 2010, the annual incidence of CPP rose steeply, in particular, among girls. In this study, we demonstrated that the overall prevalence of CPP among Korean children in 2010 was 26.1 per 100,000 children, with a prevalence of 55.9 per 100,000 girls and 1.7 per 100,000 boys. New cases of CPP were defined as those children who claimed GnRHa treatment for the first time to HIRA. In addition, patients of both genders and of the same ages who had made insurance claims for GnRHa treatment based on a CPP diagnosis during the same study period were included in the investigation. We included boys aged <9 years and girls aged <8 years who visited hospitals for evaluations of CPP and registered with HIRA for the first time with an ICD-10 diagnosis of precocious puberty from 2004 to 2010. Insurance claims for gonadotropin-releasing hormone analogs (GnRHa) are possible when a diagnosis of CPP is confirmed using the following criteria: the appearance of secondary sex characteristics defined as breast development in girls aged 4 mL) combined with growth acceleration, the presence of advanced bone age, and documentation of a pubertal hormonal response defined as a peak luteinizing hormone of >5 IU/L after gonadotropin-releasing hormone (GnRH) stimulation testing. In this report, we aimed to investigate the prevalence and incidence of CPP among Korean children, using data from a national registry.Īll Korean people who visit hospitals are registered with the Korean Health Insurance Review Agency (HIRA), and their diagnoses are recorded for health insurance claims according to the International Classification of Diseases, 10th Revision (ICD-10) coding system. There is a possibility that the prevalence and incidence of CPP might have increased over the past decades, as pubertal timing has accelerated in the general population with no changes in the diagnostic criteria of CPP.Īdditional epidemiologic data is needed to establish optimal guidelines for the diagnosis and treatment of CPP. This secular trend of earlier occurrence of puberty is also apparent in Korea. The mean age of pubertal onset in girls and boys has declined over the last 2 decades in countries including the United States of America, European nations, and China. Diagnostic age limits were arbitrarily derived from studies on normal pubertal development in the general population, therefore, these age limits may change over time with secular trends. Proper diagnosis and treatment can help to avoid these negative consequences. CPP can cause early menarche in girls, loss of final height due to early epiphyseal fusion, and psychosocial problems especially in those with early onset and rapid progression. If precocious puberty results from the premature maturation of hypothalamic-pituitary-gonadal axis, the condition is called central precocious puberty (CPP). This is classified as central or peripheral precocious puberty according to the primary source of the hormonal production. Precocious puberty is generally defined by the onset of secondary sexual characteristics before the age of 8 yrs in girls and 9yrs in boys.
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