Diagnostic evaluation of central precocious puberty in girls
Background: The gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard for confirming the activation of the hypothalamic–pituitary–gonadal axis in central precocious puberty (CPP). However, it is time-consuming and costly. Our aim was to search for a simpler diagnostic modality...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-03-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957220301996 |
| _version_ | 1826574991191179264 |
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| author | Shu-Nin Yeh Wei-Hsin Ting Chi-Yu Huang Shih-Kang Huang Yi-Chen Lee Wei-Kian Chua Chao-Hsu Lin Bi-Wen Cheng Yann-Jinn Lee |
| author_facet | Shu-Nin Yeh Wei-Hsin Ting Chi-Yu Huang Shih-Kang Huang Yi-Chen Lee Wei-Kian Chua Chao-Hsu Lin Bi-Wen Cheng Yann-Jinn Lee |
| author_sort | Shu-Nin Yeh |
| collection | DOAJ |
| description | Background: The gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard for confirming the activation of the hypothalamic–pituitary–gonadal axis in central precocious puberty (CPP). However, it is time-consuming and costly. Our aim was to search for a simpler diagnostic modality for CPP by 1) evaluating the performance of basal serum luteinizing hormone (LH), 2) constructing a practical scoring system, and 3) determining the optimal single sampling time for serum LH in the GnRH stimulation test. Methods: Data of girls aged between 3 and 9 years at the time of the GnRH stimulation test, who attended our endocrine clinic at the MacKay Children's Hospital for signs of puberty between July 2014 and June 2019, were analyzed retrospectively. We recorded patients' age, height, weight, breast Tanner stage (BS), bone age, serum LH, and follicle-stimulating hormone (FSH). Receiver operating characteristic (ROC) curves and the Youden index were used to obtain the optimal basal serum LH level. Binary logistic regression was employed to construct a practical scoring system. Cross-sectional, cumulative frequency, and ROC curves were used to simplify the GnRH stimulation test. Results: Overall, 381 sets of GnRH stimulation tests were performed in 313 patients. Basal serum LH ≥ 0.2 IU/L demonstrated 70% sensitivity and 70% specificity for predicting positive GnRH stimulation test results. The practical scoring system (3 × BS + 3 × LH + 4 × FSH) showed 76% sensitivity and 72% specificity. The serum LH level at 30 min after intravenous gonadorelin exhibited 99% sensitivity and 100% specificity. Conclusion: Single sampling of serum LH at 30th minute post-injection of GnRH demonstrated a diagnostic performance equivalent to the traditional GnRH stimulation test in diagnosing CPP. Therefore, this approach could become the simplest diagnostic modality. |
| first_indexed | 2024-12-13T16:14:35Z |
| format | Article |
| id | doaj.art-f4c503403e2e4a229de8e090e8d072a8 |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2025-03-14T13:07:36Z |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-f4c503403e2e4a229de8e090e8d072a82025-03-02T00:55:44ZengElsevierPediatrics and Neonatology1875-95722021-03-01622187194Diagnostic evaluation of central precocious puberty in girlsShu-Nin Yeh0Wei-Hsin Ting1Chi-Yu Huang2Shih-Kang Huang3Yi-Chen Lee4Wei-Kian Chua5Chao-Hsu Lin6Bi-Wen Cheng7Yann-Jinn Lee8Department of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan; Department of Pediatrics, Saint Paul's Hospital, Taoyuan City, TaiwanDepartment of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine Nursing and Management, New Taipei City, Taiwan; Corresponding author. Department of Pediatric Endocrinology, MacKay Children's Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Taipei City 104, Taiwan. Fax: +886 2 25232448.Department of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, TaiwanDepartment of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatric Endocrinology, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan; Department of Biological Science and Technology, National Chiao-Tung University, Hsinchu City, TaiwanDepartment of Pediatric Endocrinology, Hsinchu MacKay Memorial Hospital, Hsinchu City, TaiwanDepartment of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Department of Medical Research, Tamsui MacKay Memorial Hospital, New Taipei City, Taiwan; Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, TaiwanBackground: The gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard for confirming the activation of the hypothalamic–pituitary–gonadal axis in central precocious puberty (CPP). However, it is time-consuming and costly. Our aim was to search for a simpler diagnostic modality for CPP by 1) evaluating the performance of basal serum luteinizing hormone (LH), 2) constructing a practical scoring system, and 3) determining the optimal single sampling time for serum LH in the GnRH stimulation test. Methods: Data of girls aged between 3 and 9 years at the time of the GnRH stimulation test, who attended our endocrine clinic at the MacKay Children's Hospital for signs of puberty between July 2014 and June 2019, were analyzed retrospectively. We recorded patients' age, height, weight, breast Tanner stage (BS), bone age, serum LH, and follicle-stimulating hormone (FSH). Receiver operating characteristic (ROC) curves and the Youden index were used to obtain the optimal basal serum LH level. Binary logistic regression was employed to construct a practical scoring system. Cross-sectional, cumulative frequency, and ROC curves were used to simplify the GnRH stimulation test. Results: Overall, 381 sets of GnRH stimulation tests were performed in 313 patients. Basal serum LH ≥ 0.2 IU/L demonstrated 70% sensitivity and 70% specificity for predicting positive GnRH stimulation test results. The practical scoring system (3 × BS + 3 × LH + 4 × FSH) showed 76% sensitivity and 72% specificity. The serum LH level at 30 min after intravenous gonadorelin exhibited 99% sensitivity and 100% specificity. Conclusion: Single sampling of serum LH at 30th minute post-injection of GnRH demonstrated a diagnostic performance equivalent to the traditional GnRH stimulation test in diagnosing CPP. Therefore, this approach could become the simplest diagnostic modality.http://www.sciencedirect.com/science/article/pii/S1875957220301996gonadotropin-releasing hormone stimulation testluteinizing hormoneprecocious puberty |
| spellingShingle | Shu-Nin Yeh Wei-Hsin Ting Chi-Yu Huang Shih-Kang Huang Yi-Chen Lee Wei-Kian Chua Chao-Hsu Lin Bi-Wen Cheng Yann-Jinn Lee Diagnostic evaluation of central precocious puberty in girls Pediatrics and Neonatology gonadotropin-releasing hormone stimulation test luteinizing hormone precocious puberty |
| title | Diagnostic evaluation of central precocious puberty in girls |
| title_full | Diagnostic evaluation of central precocious puberty in girls |
| title_fullStr | Diagnostic evaluation of central precocious puberty in girls |
| title_full_unstemmed | Diagnostic evaluation of central precocious puberty in girls |
| title_short | Diagnostic evaluation of central precocious puberty in girls |
| title_sort | diagnostic evaluation of central precocious puberty in girls |
| topic | gonadotropin-releasing hormone stimulation test luteinizing hormone precocious puberty |
| url | http://www.sciencedirect.com/science/article/pii/S1875957220301996 |
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