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Factors that predict a positive response on gonadotropin-releasing hormone stimulation test for diagnosing central precocious puberty in girls

Authors
 Junghwan Suh  ;  Myung Hyun Choi  ;  Ah Reum Kwon  ;  Ye Jin Kim  ;  Jin Woo Jeong  ;  Jung Min Ahn  ;  Hyun Wook Chae  ;  Duk Hee Kim  ;  Ho-Seong Kim 
Citation
 Annals of Pediatric Endocrinology & Metabolism, Vol.18(4) : 202-207, 2013 
Journal Title
 Annals of Pediatric Endocrinology & Metabolism 
ISSN
 2287-1012 
Issue Date
2013
Keywords
Diagnosis ; Female ; Forecasting ; Gonadotropin-releasing hormone ; Precocious puberty
Abstract
Purpose The rapid increase in the incidence of precocious puberty in Korea has clinical and social significance. Gonadotropin-releasing hormone (GnRH) stimulation test is required to diagnose central precocious puberty (CPP), however this test is expensive and time-consuming. This study aimed to identify factors that can predict a positive response to the GnRH stimulation test. Methods Clinical and laboratory parameters, including basal serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol (E2), were measured in 540 girls with clinical signs of CPP. Results Two hundred twenty-nine of 540 girls with suspected CPP had a peak serum LH level higher than 5 IU/L (the CPP group). The CPP group had advanced bone age (P<0.001), accelerated yearly growth rate (P<0.001), increased basal levels of LH (P=0.02), FSH (P<0.001), E2 (P=0.001), and insulin-like growth factor-I levels (P<0.001) compared to the non-CPP group. In contrast, body weight (P<0.001) and body mass index (P<0.001) were lower in the CPP group. Although basal LH was significantly elevated in the CPP group compared to the non-CPP group, there was considerable overlap between the 2 groups. Cutoff values of basal LH (0.22 IU/L) detected CPP with 87.8% sensitivity and 20.9% specificity. Conclusion No single parameter can predict a positive response on the GnRH stimulation test with both high sensitivity and specificity. Therefore, multiple factors should be considered in evaluation of sexual precocity when deciding the timing of the GnRH stimulation test.
Files in This Item:
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DOI
10.6065/apem.2013.18.4.202
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ah Reum(권아름) ORCID logo https://orcid.org/0000-0002-9692-2135
Kim, Ye Jin(김예진)
Kim, Ho Seong(김호성) ORCID logo https://orcid.org/0000-0003-1135-099X
Ahn, Jung Min(안정민)
Jeong, Jin Woo(정진우)
Chae, Hyun Wook(채현욱) ORCID logo https://orcid.org/0000-0001-5016-8539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88899
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