Yazdani Parvin, Lin Yuezhen, Raman Vandana, Haymond Morey
Pediatric Endocrinology, Baylor College of Medicine, Houston, 77024, TX, USA.
Int J Pediatr Endocrinol. 2012 Jul 18;2012(1):23. doi: 10.1186/1687-9856-2012-23.
Gonadotropin-releasing hormone (GnRH) has been the standard test for diagnosing central precocious puberty. Because GnRH is no longer available, GnRH analogues (GnRHa) are now used. Random LH concentration, measured by the third-generation immunochemiluminometric assay, is a useful screening tool for central precocious puberty. However, GnRHa stimulation test should be considered, when a basal LH measurement is inconclusive. However optimal sampling times for luteinizing hormone (LH) have yet to be established.
To determine the appropriate sampling time for LH post leuprolide challenge.
A retrospective analysis of multi-sample GnRHa stimulation tests performed in 155 children (aged 1-9 years) referred for precocious puberty to Texas Children's Hospital.After 20 mcg/kg of SQ leuprolide acetate, samples were obtained at 0, 1, 3, and 6 hours.
Of 71 children with clinical evidence of central precocious puberty, fifty nine children had a peak LH >5 mIU/mL. 52 (88%) of these responders had positive responses at 1 hour (95% CI is 80-96%), whereas all 59 children (100%) had a peak LH response >5 mIU/mL at 3 hours (95% CI is 94-100%), P = 0.005.
A single serum LH sample collected 3 hours post GnRHa challenge is the optimal sample to establish the diagnosis of central precocious puberty.
促性腺激素释放激素（GnRH）一直是诊断中枢性性早熟的标准检测方法。由于GnRH已不再可用，现在使用GnRH类似物（GnRHa）。通过第三代免疫化学发光测定法测量的随机促黄体生成素（LH）浓度，是中枢性性早熟的一种有用筛查工具。然而，当基础LH测量结果不明确时，应考虑进行GnRHa刺激试验。然而，促黄体生成素（LH）的最佳采样时间尚未确定。
确定亮丙瑞林激发后LH的合适采样时间。
对155名因性早熟转诊至德克萨斯儿童医院的儿童（年龄1 - 9岁）进行的多样本GnRHa刺激试验进行回顾性分析。在给予20 mcg/kg的皮下注射醋酸亮丙瑞林后，于0、1、3和6小时采集样本。
在71名有中枢性性早熟临床证据的儿童中，59名儿童的LH峰值>5 mIU/mL。这些有反应者中有52名（88%）在1小时时有阳性反应（95%置信区间为80 - 96%），而所有59名儿童（100%）在3小时时LH峰值反应>5 mIU/mL（95%置信区间为94 - 100%），P = 0.005。
GnRHa激发后3小时采集的单次血清LH样本是确立中枢性性早熟诊断的最佳样本。
