根据两种不同的促黄体生成素释放激素刺激试验临界值评估女童促性腺激素反应及反应时间
Evaluation of Gonadotropin Responses and Response Times According to Two Different Cut-Off Values in Luteinizing Hormone Releasing Hormone Stimulation Test in Girls.
作者信息
Özalkak Şervan, Çetinkaya Semra, Budak Fatma Can, Erdeve Şenay Savaş, Aycan Zehra
机构信息
Department of Pediatric Endocrinology, University of Health Sciences, Dr. Sami Ulus Training and Research Hospital, Clinic of Children's Health and Disease, Altındağ/Ankara, Turkey.
出版信息
Indian J Endocrinol Metab. 2020 Sep-Oct;24(5):410-415. doi: 10.4103/ijem.IJEM_314_20. Epub 2020 Nov 9.
BACKGROUND
In this study, we aimed to evaluate FSH, LH responses obtained during LHRH-ST according to two different cut-off values, to determine the diagnostic response times, and to find the optimal blood collection times that could reduce the economic and time burden of LHRH-ST.
MATERIALS AND METHODS
Patients who underwent LHRH-ST in our clinic with the preliminary diagnosis of precocious puberty (PP) between 01/08/2016 and 31/12/2017 were retrospectively enrolled to the study. In this study 207 girls with PP were included and some of them (102 according to C1 and 139 according to C2) had central PP (CPP). Test response and response times were evaluated according to both cut-off values of stimulated peak LH pubertal responses as 5 mIU/ml (the 1 cut-off = C1) and 3.3 mIU/ml (the 2 cut-off = C2).
RESULTS
Totally, 207 girls with a mean age of 7.5 ± 1.22 (3.4-9.5) years were included in the study. With LHRH-ST; 49.2% ( = 102), 67% ( = 139) of the cases were in pubertal period according to C1, C2, respectively. According to C1; pubertal LH was present in 94.1% ( = 96) of 102 patients who reached pubertal LH value in 45 minutes. The highest pubertal response was obtained in the 45 minute. According to C2, of 139 patients who reached pubertal LH; pubertal LH was determined in 98.5% ( = 137) in the 45 minute. Pubertal LH levels were determined according to both cut-off values in all 27 patients with baseline LH ≥0.31 mIU/ml.
CONCLUSION
It was determined that measuring LH at 45 minutes during LHRH-ST was sufficient in 94.1% of the cases according to C1 and 97.1% of the cases according to C2. It was concluded that the 30, 45, and 60 minute samples were enough to assess pubertal LH response in 100%of the cases. If the basal LH is found to be ≥0.31 mIU/ml in girls with puberty findings, we recommend that the diagnosis of precocious puberty would be made without performing LHRH-ST.
背景
在本研究中，我们旨在根据两个不同的临界值评估促性腺激素释放激素激发试验（LHRH-ST）期间获得的促卵泡生成素（FSH）、促黄体生成素（LH）反应，确定诊断反应时间，并找到能够减轻LHRH-ST经济和时间负担的最佳采血时间。
材料与方法
回顾性纳入2016年8月1日至2017年12月31日在我院初步诊断为性早熟（PP）并接受LHRH-ST的患者。本研究纳入了207例PP女童，其中部分患者（根据C1标准为102例，根据C2标准为139例）患有中枢性性早熟（CPP）。根据促黄体生成素（LH）激发峰值青春期反应的两个临界值，即5 mIU/ml（临界值1 = C1）和3.3 mIU/ml（临界值2 = C2），评估试验反应和反应时间。
结果
本研究共纳入207例平均年龄为7.5±1.22（3.4 - 9.5）岁的女童。通过LHRH-ST；根据C1、C2标准，分别有49.2%（n = 102）、67%（n = 139）的病例处于青春期。根据C1标准；在45分钟内达到青春期LH值的102例患者中，94.1%（n = 96）出现青春期LH。在45分钟时获得最高青春期反应。根据C2标准，在达到青春期LH的139例患者中；45分钟时98.5%（n = 137）检测到青春期LH。在所有27例基线LH≥0.31 mIU/ml的患者中，根据两个临界值均测定了青春期LH水平。
结论
根据C1标准，在LHRH-ST期间45分钟测量LH在94.1%的病例中足够，根据C2标准在97.1%的病例中足够。得出结论，30、45和60分钟的样本足以在100%的病例中评估青春期LH反应。如果青春期有表现的女童基础LH≥0.31 mIU/ml，我们建议不进行LHRH-ST即可诊断性早熟。
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