Tripathy Manoranjan, Baliarsinha A K, Choudhury A K, Das Upendra K
Department of Endocrinology, SCB MCH, Cuttack, Odisha, India.
Department of Biochemistry, SCB MCH, Cuttack, Odisha, India.
Indian J Endocrinol Metab. 2021 Mar-Apr;25(2):110-120. doi: 10.4103/ijem.IJEM_47_21. Epub 2021 Sep 8.
Various hormonal parameters used to differentiate between different causes of pubertal disorders are invasive, cumbersome, and has variable sensitivity and specificity. Thus, the use of a noninvasive test like urinary gonadotropin for the diagnosis of pubertal disorders will offer a significant advantage.
To study the role of urinary gonadotropins (uLH, uFSH) for the diagnosis of various pubertal disorders and in the monitoring of Gonadotrophin releasing hormone, Hypothalamic-pituitary-gonadal (GnRHa) therapy in patients with central precocious puberty (CPP).
We evaluated 35 healthy children and 96 patients with disorders of puberty out of which 31 cases had early puberty and 65 cases had delayed puberty. We used Spearman's correlation coefficient to evaluate the correlation between the serum and urinary gonadotropins. We used Mann-Whitney U test (for 2 groups) and Kruskal-Wallis test (for > 2 groups) to compare the median urinary and serum gonadotropins of different groups.
The urinary gonadotropins correlated strongly with serum gonadotropins in both healthy controls and individuals with pubertal disorders. The uLH level of ≥0.76 IU/L had 100% sensitivity and specificity to differentiate CPP from peripheral precocious puberty, whereas uLH level of ≥1.07 IU/L had 100% sensitivity and specificity for differentiating CPP from PT. In patients with delayed puberty, uFSH of ≥20.51 IU/L had 94.7% sensitivity and 91.3% specificity for the diagnosis of Hyper-Hypo cases and uLH level of ≥0.5 IU/L had sensitivity of 96.2% and specificity of 85% to differentiate constitutional delay in growth and puberty from hypogonadotropic-hypogonadism. In CPP patients on GnRHa therapy, the uLH level of ≥0.13 IU/L had 100% sensitivity and 86.7% specificity to identify those who had nonsuppressed serum LH levels.
The urinary gonadotropins can be used as a reliable noninvasive test for the diagnosis of various pubertal disorders and also for monitoring of CPP patients on GnRHa therapy.
用于区分青春期障碍不同病因的各种激素参数具有侵入性、操作繁琐，且敏感性和特异性各不相同。因此，使用像尿促性腺激素这样的非侵入性检测方法来诊断青春期障碍将具有显著优势。
研究尿促性腺激素（uLH、uFSH）在诊断各种青春期障碍以及监测中枢性性早熟（CPP）患者的促性腺激素释放激素、下丘脑 - 垂体 - 性腺（GnRHa）治疗中的作用。
我们评估了35名健康儿童和96名青春期障碍患者，其中31例为性早熟，65例为青春期延迟。我们使用Spearman相关系数来评估血清和尿促性腺激素之间的相关性。我们使用Mann - Whitney U检验（用于两组）和Kruskal - Wallis检验（用于超过两组）来比较不同组的尿和血清促性腺激素中位数。
在健康对照者和青春期障碍个体中，尿促性腺激素与血清促性腺激素均密切相关。uLH水平≥0.76 IU/L用于区分CPP与外周性性早熟时，敏感性和特异性均为100%，而uLH水平≥1.07 IU/L用于区分CPP与PT时，敏感性和特异性也均为100%。在青春期延迟患者中，uFSH≥20.51 IU/L用于诊断高 - 低促性腺激素性性腺功能减退病例时，敏感性为94.7%，特异性为91.3%；uLH水平≥0.5 IU/L用于区分体质性生长和青春期延迟与低促性腺激素性性腺功能减退时，敏感性为96.2%，特异性为85%。在接受GnRHa治疗的CPP患者中，uLH水平≥0.13 IU/L用于识别血清LH水平未被抑制的患者时，敏感性为100%，特异性为86.7%。
尿促性腺激素可作为一种可靠的非侵入性检测方法，用于诊断各种青春期障碍以及监测接受GnRHa治疗的CPP患者。
