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Morning basal luteinizing hormone, a good screening tool for diagnosing central precocious puberty

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주제분류소아과학

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Purpose: The standard method used to diagnose central precocious puberty (CPP) is the gonadotropin releasing hormone stimulation test (GnRHST). However, this test is inconvenient for children because it is time-consuming and requires multiple samples. This study aimed to determine the reliability of morning unstimulated luteinizing hormone (mLH) level when screening for CPP, with an emphasis on the influence of diurnal variation. Methods: This study included 160 girls with signs of early puberty (SMR 2) under 8 years of age. They were classified as CPP or non-CPP based on their standard GnRHST. The auxological, biochemical, and hormonal characteristics of subjects were retrospectively evaluated. The prognostic value of single morning unstimulated gonadotropin level was examined for use in CPP screening. Results: Of 160 patients, 121 (75.6%) presented with CPP, and 39 (24.4%) were determined to be prepubertal. The mLH/mFSH (morning unstimulated follicular stimulating hormone) ratio showed significant differences between the 2 groups (P<0.001). The mLH was correlated with GnRHST variables (r=0.532, P<0.001). The mLH cutoff point when screening for CPP was 0.22 IU/L, which had sensitivity and specificity of 69.4% and 82.1%, respectively. In regression analysis, bone age (BA) (odds ratio [OR], 1.018; 95% confidence interval [CI], 0.967–1.071; P=0.506) and body mass index (BMI) (OR, 0.874; 95% CI, 0.583–1.310; P=0.515) were not significant predictors. The mLH≥0.22 IU/L group (OR, 9.596; 95% CI, 3.853–23.900; P<0.001) was highly suggestive of CPP. Conclusion: In this study, single morning unstimulated luteinizing hormone had clinical efficacy for CPP screening, but BA advanced over chronological age and BMI was not useful for CPP screening.

Abstract

Purpose: The standard method used to diagnose central precocious puberty (CPP) is the gonadotropin releasing hormone stimulation test (GnRHST). However, this test is inconvenient for children because it is time-consuming and requires multiple samples. This study aimed to determine the reliability of morning unstimulated luteinizing hormone (mLH) level when screening for CPP, with an emphasis on the influence of diurnal variation. Methods: This study included 160 girls with signs of early puberty (SMR 2) under 8 years of age. They were classified as CPP or non-CPP based on their standard GnRHST. The auxological, biochemical, and hormonal characteristics of subjects were retrospectively evaluated. The prognostic value of single morning unstimulated gonadotropin level was examined for use in CPP screening. Results: Of 160 patients, 121 (75.6%) presented with CPP, and 39 (24.4%) were determined to be prepubertal. The mLH/mFSH (morning unstimulated follicular stimulating hormone) ratio showed significant differences between the 2 groups (P<0.001). The mLH was correlated with GnRHST variables (r=0.532, P<0.001). The mLH cutoff point when screening for CPP was 0.22 IU/L, which had sensitivity and specificity of 69.4% and 82.1%, respectively. In regression analysis, bone age (BA) (odds ratio [OR], 1.018; 95% confidence interval [CI], 0.967–1.071; P=0.506) and body mass index (BMI) (OR, 0.874; 95% CI, 0.583–1.310; P=0.515) were not significant predictors. The mLH≥0.22 IU/L group (OR, 9.596; 95% CI, 3.853–23.900; P<0.001) was highly suggestive of CPP. Conclusion: In this study, single morning unstimulated luteinizing hormone had clinical efficacy for CPP screening, but BA advanced over chronological age and BMI was not useful for CPP screening.

참고문헌 (38)

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관련 논문AI추천

Basal serum luteinizing hormone value as the screening biomarker in female central precocious pubertyJeesuk Yu, You Jung Heo, Young Seok Lee대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2019 · 제24권 제3호The Utility of Basal Serum Luteinizing Hormone Levels for Screening Central Precocious Puberty in Girls곽민정, 이영아, 이혜령, 정상건, 주정기영남대학교 의과대학 · Journal of Yeungnam Medical Science2013 · 제30권 제2호Basal luteinizing hormone and follicular stimulating hormone: is it sufficient for the diagnosis of precocious puberty in girls?김솔잎, 김재현, 류나영, 이동성, 이선희대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2013 · 제18권 제4호Single random measurement of urinary gonadotropin concentration for screening and monitoring girls with central precocious puberty김유미, 임한혁, Kim Ji Myung, Lee Se Young대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2021 · 제26권 제3호Factors that predict a positive response on gonadotropin-releasing hormone stimulation test for diagnosing central precocious puberty in girls권아름, 김덕희, 김예진, 김호성, 서정환, 안정민, 정진우, 채현욱, 최명현대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2013 · 제18권 제4호Diurnal variation of gonadotropin levels in girls with early stages of puberty강유선, 유동윤, 유은경, 정인혁대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2017 · 제22권 제3호

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