The demographic-adjusted odds ratio (OR) and 95 per cent CI for incident MetS per SD greater log-pro-NT/NMN were 1.22, 1.16 for incident low high-density lipoprotein (HDL), and 1.25 for incident dysglycemia. The model with HOMA-IR reduced the relationship of pro-NT/NMN with MetS. There was no link to the incident DM. Cutoffs for baseline and FSH-stimulated inhibin B (FSH-iB) obtained from the exploratory cohort were applied to the validation cohort. For the prediction of puberty onset, baseline LH, GnRH analogue-stimulated LH, basal inhibin B, and FSH-iB were compared with clinical outcomes on a prospective follow-up. In both male and female participants, there was a statistically significant increase in inhibin B following exogenous FSH in group 1 (SP). In both sexes, the increase in group 2 (HH) was not statistically significant. FSH-iB exhibited 100 per cent sensitivity and specificity for labelling puberty at a cutoff of 116.14 pg/mL in men and 116.50 pg/mL in females. When these cutoffs were applied to the validation group, FSH-iB exhibited 100% positive predictive value, negative predictive value, and diagnostic accuracy for predicting pubertal onset.

Both male and female participants were stimulated by Inhibin B. FSH-iB is a unique and promising study for predicting the beginning of puberty.