The utilization of basal luteinizing hormone in combination with the basal luteinizing hormone and follicle-stimulating hormone ratio as a diagnostic tool for central precocious puberty in girls

Chotipakornkul Nuntika; Onsoi Witchuwan; Numsriskulrat Nattakarn; Aroonparkmongkol Suphab; Supornsilchai Vichit; Srilanchakon Khomsak

doi:10.6065/apem.2346072.036

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자료유형: 학술저널

저자정보: Chotipakornkul Nuntika (Department of Pediatrics Faculty of Medicine Chulalongkorn University Bangkok Thailand) Onsoi Witchuwan (Division of Pediatric Endocrinology Department of Pediatrics Faculty of medicine Chulalongkorn University Bangkok Thailand) Numsriskulrat Nattakarn (Division of Pediatric Endocrinology Department of Pediatrics Faculty of medicine Chulalongkorn University Bangkok Thailand) Aroonparkmongkol Suphab (Division of Pediatric Endocrinology Department of Pediatrics Faculty of medicine Chulalongkorn University Bangkok Thailand) Supornsilchai Vichit (Division of Pediatric Endocrinology Department of Pediatrics Faculty of medicine Chulalongkorn University Bangkok Thailand) Srilanchakon Khomsak (Division of Pediatric Endocrinology Department of Pediatrics Faculty of medicine Chulalongkorn University Bangkok Thailand)

저널정보: 대한소아내분비학회 Annals of Pediatirc Endocrinology & Metabolism Annals of Pediatric Endocrinology & Metabolism 제28권 제2호

발행연도: 2023.6

수록면: 138 - 143 (6page)

DOI: 10.6065/apem.2346072.036

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Purpose: Intravenous gonadotropin-releasing hormone (IV GnRH) testing is the gold standard for confirming a central precocious puberty (CPP) diagnosis. However, this test is not widely available commercially. Therefore, our study aim was to establish cutoff values for basal gonadotropin level and gonadotrophin responses to a 100-μg subcutaneous IV GnRH test that can distinguish between CPP and premature thelarche (PT) to discover a simple method to detect CPP. Methods: Girls between the ages of 6 and 8 years who attended the pediatric endocrinology outpatient clinic at our tertiary hospital between 2019 and 2022 were included in this study. They were evaluated for breast development, and a subcutaneous 100-μg GnRH test was administered by measuring the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in blood samples at baseline and then 30, 60, 90, and 120 minutes after injection. CPP is characterized by increased height velocity, advanced bone age, and progression of breast development. The cutoff value for diagnosis of CPP was determined using a receiver operating characteristic (ROC) analysis. Results: In 86 Thai girls (56 with CPP and 30 with PT), the ROC analysis showed 71.4% and 100% sensitivity and specificity, respectively, for basal LH (cutoff ≥ 0.2 IU/L) plus the basal LH/FSH ratio (cutoff ≥ 0.1). The optimal cutoff values for peak LH (cutoff ≥ 7 IU/L) demonstrated a sensitivity of 94.6% and a specificity of 100%, whereas the LH value at 30 and 60 minutes after injection (cutoff ≥ 6 IU/L) demonstrated sensitivities of 92.9% and 94.6% and a specificity of 100%, respectively Conclusion: Combining the basal LH (cutoff: 0.2 IU/L) and the basal LH/FSH ratio (cutoff: 0.1) can easily and cost-effectively diagnose CPP in a girl in breast Tanner stage II.

#Central precocious puberty #Premature thelarche #Luteinizing hormone #Follicle-stimulating hormone

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Chotipakornkul Nuntika

소속기관 Department of Pediatrics Faculty of Medicine Chulalongkorn University Bangkok Thailand

주요연구분야 의약학 > 임상의학 > 소아과학

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Onsoi Witchuwan