GnRH Stimulation Test in Precocious Puberty: Single Sample is Adequate for Diagnosis and Dose Adjustment

Kandemir, Nurgün; Demirbilek, Hüseyin; Özön, Z. Alev; Gönç, E. Nazlı; Alikaşifoğlu, Ayfer

doi:10.4274/jcrpe.v3i1.03

Cited by 40 publications

(41 citation statements)

References 23 publications

(35 reference statements)

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“…4 It has been reported that the mean peak-stimulated FSH does not distinguish between prepubertal and pubertal status. 19,20 Nevertheless, in our study, the mean peak-stimulated FSH levels in the pubertal response group were significantly higher than in the prepubertal response group (p<0.05).…”

Section: Discussioncontrasting

confidence: 38%

The Utility of Basal Serum Luteinizing Hormone Levels for Screening Central Precocious Puberty in Girls

Ju¹,

Lee²,

Lee³

et al. 2013

Yeungnam Univ J Med

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Background: This study was conducted to examine if basal luteinizing hormone (LH) levels could be useful for screening central precocious puberty (CPP) in girls. Methods: A total of 90 girls under the age of 8 years were included in this study. They underwent the gonadotropin-releasing hormone (GnRH) stimulation test at Good Gang-An Hospital from March 2008 to December 2012 for evaluation of premature sexual development. Patients were classified into two groups: the pubertal response group of patients who had 5 IU/L peak LH levels in the GnRH stimulation test, and the prepubertal response group of patients who had LH levels <5 IU/L. Chronological and bone ages, height, weight, body mass index, gonadotropin response to GnRH stimulation, and basal levels of LH, follicle-stimulating hormone, and estradiol were studied in both groups. The relationship between basal LH and peak-stimulated LH was evaluated using Spearman's correlation. To determine the optimal cut-off values of basal LH levels for differentiating between two groups, the receiver operating characteristic (ROC) curves were analyzed. Results: When the correlation between basal LH levels and peak LH after GnRH stimulation was analyzed in all subjects (N=90), basal LH levels had a statistically significant positive correlation with peak stimulated LH levels (rs=0.493, p<0.001). The cut-off level of optimal basal LH was 0.1 IU/L, according to the ROC curves. Its sensitivity was 73.3%, and its specificity was 77.8%. Conclusion:The study results showed that serum basal LH levels are useful for screening CPP in girls.

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Section: Discussioncontrasting

confidence: 38%

The Utility of Basal Serum Luteinizing Hormone Levels for Screening Central Precocious Puberty in Girls

Ju¹,

Lee²,

Lee³

et al. 2013

Yeungnam Univ J Med

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show abstract

“…Owing to the fact that basal and peak LH levels are elevated with advanced stage of puberty, a mixed study population of girls with different Tanner stages could be a factor that has caused different basal and peak LH cut-offs and their diagnostic accuracy for diagnosing CPP. [3][4][5]9,10,18,[21][22][23][24][25] Different Tanner stages of CPP girls might have different LH cut-offs for the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Among studies using either GnRH or GnRHa test for diagnosing girls with CPP, basal LH cut-offs of 0.1-0.6 IU/L have provided sensitivity of 35%-76% and specificity of 80%-100% while peak LH cutoffs of 5.0-6.9 IU/L showed sensitivity and specificity of 78%-93% and 91%-100%, respectively. 4,5,[8][9][10] However, those studies included CPP girls with both early and advanced stages of breast development. None of those studies evaluated the accuracy of the cut-offs for each breast stage especially CPP girls with early stage of breast development.…”

mentioning

confidence: 99%

Basal serum luteinising hormone cut‐off, and its utility and cost‐effectiveness for aiding the diagnosis of the onset of puberty in girls with early stages of breast development

Wankanit

Mahachoklertwattana

Pattanaprateep

et al. 2019

Clinical Endocrinology

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Objective To determine basal and gonadotrophin‐releasing hormone analogue (GnRHa)‐stimulated peak luteinising hormone (LH) cut‐offs to diagnose onset of early or normal puberty in girls with each Tanner stage of breast (II and III). Design, Patients and Measurements A retrospective study of 601 girls with breast onset before 8 years of age who underwent GnRHa test was conducted. Patients were categorized as CPP and premature thelarche. Each group was divided into two subgroups; Tanner II and III. Cost‐effectiveness analysis was performed. Results In comparison with basal LH cut‐off of 0.3 IU/L, basal LH cut‐off of 0.2 IU/L had comparable specificity (Tanner II: 98.0% vs 94.8%, Tanner III: 98.8% vs 93.8%), but greater sensitivity (Tanner II: 28.3% vs 41.7%, Tanner III: 45.2% vs 59.3%). Specificity of basal LH cut‐off of 0.2 IU/L was not inferior to that of the traditionally used peak LH of 5 IU/L. Using basal LH cut‐off of 0.2 IU/L followed by GnRHa test in girls with negative basal LH was more cost‐saving when compared with using the cut‐off of 0.3 IU/L. Moreover, using basal LH cut‐off of 0.2 IU/L followed by GnRHa test provided a cost reduction when compared with performing GnRHa test in all patients. Conclusions Basal serum LH cut‐off of 0.2 IU/L could be a simple and cost‐saving tool for initial diagnosis of onset of early or normal puberty in girls with Tanner II and III before proceeding to GnRH testing.

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“…Recently, in a large-scale study, we showed that single LH measurement 20 min after iv GnRH test is adequate for the assessment of pubertal suppression. 15 Although this would simplify iv GnRH test, it does not totally eliminate the requirement of an additional iv injection of GnRH to stimulate gonadotrophins for the assessment of pubertal suppression.…”

Section: Discussionmentioning

confidence: 99%

Assessment of gonadotrophin suppression in girls treated with GnRH analogue for central precocious puberty; validity of single luteinizing hormone measurement after leuprolide acetate injection

Demirbilek

Alikaşifoğlu

Gönç

et al. 2011

Clinical Endocrinology

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GnRH Stimulation Test in Precocious Puberty: Single Sample is Adequate for Diagnosis and Dose Adjustment

Cited by 40 publications

References 23 publications

The Utility of Basal Serum Luteinizing Hormone Levels for Screening Central Precocious Puberty in Girls

The Utility of Basal Serum Luteinizing Hormone Levels for Screening Central Precocious Puberty in Girls

Basal serum luteinising hormone cut‐off, and its utility and cost‐effectiveness for aiding the diagnosis of the onset of puberty in girls with early stages of breast development

Assessment of gonadotrophin suppression in girls treated with GnRH analogue for central precocious puberty; validity of single luteinizing hormone measurement after leuprolide acetate injection

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