Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
Horm Metab Res. 2012 Oct;44(11):851-4. doi: 10.1055/s-0032-1321905. Epub 2012 Aug 14.
The hallmark of puberty is the progressive increase in gonadotropin-releasing hormone (GnRH) activity, reflected by an increase in the circulating concentration of luteinizing hormone (LH). The GnRH stimulation test is widely used in the evaluation of precocious puberty. The aim of our study was to assess the diagnostic utility of basal LH for the diagnosis of central precocious puberty (CPP) in girls. A total of 803 girls were referred to Ajou University Hospital for evaluation of precocious puberty between 2008 and 2011. All subjects underwent GnRH-stimulation tests as part of their evaluation. Serum LH and follicle stimulating hormone (FSH) were measured by immunoradiometric assay before and after the GnRH injection. Of the 803 subjects, 505 (62.9%) were included in the pubertal response group and 298 (37.1%) were in the prepubertal response group. Basal LH level was identified as a significant predictor for CPP. Based on the ROC curve, the optimal cut off point of basal LH related to 'pubertal response' was 1.1 IU/l, which was associated with 69.1% sensitivity and 50.5% specificity, with an area under the ROC curve of 0.620 (95% CI, 0.581-0.660). It is concluded that a single basal LH measurement can be used as a screening test to identify girls with CPP and to determine who should undergo GnRH stimulation test.
青春期的标志是促性腺激素释放激素 (GnRH) 活性的逐渐增加，表现为黄体生成素 (LH) 循环浓度的增加。 GnRH 刺激试验广泛用于早熟性青春期的评估。我们的研究旨在评估基础 LH 对女孩中枢性早熟 (CPP) 的诊断效用。2008 年至 2011 年间，共有 803 名女孩因早熟性青春期问题到 Ajou 大学医院就诊。所有受试者均接受 GnRH 刺激试验作为评估的一部分。在 GnRH 注射前后，通过免疫放射测定法测量血清 LH 和卵泡刺激素 (FSH)。在 803 名受试者中，505 名（62.9%）被纳入青春期反应组，298 名（37.1%）被纳入青春期前反应组。基础 LH 水平被确定为 CPP 的重要预测因子。根据 ROC 曲线，与“青春期反应”相关的基础 LH 的最佳截断点为 1.1IU/L，其敏感性为 69.1%，特异性为 50.5%，ROC 曲线下面积为 0.620（95%CI，0.581-0.660）。结论：单次基础 LH 测量可作为一种筛选试验，用于识别 CPP 女孩，并确定谁应该接受 GnRH 刺激试验。
