尿促性腺激素在中枢性性早熟诊断中的价值：一项荟萃分析。
The value of urinary gonadotropins in the diagnosis of central precocious puberty: a meta-analysis.
机构信息
Department of Pediatrics, the First Affiliated Hospital of Nanchang University, Jiangxi, 330006, Nanchang, China.
Department of Pediatrics, The Fifth Affiliated Hospital, Sun Yat- sen University, New Xiangzhou, Zhuhai, Guangdong Province, 519000, China.
出版信息
BMC Pediatr. 2022 Jul 28;22(1):453. doi: 10.1186/s12887-022-03481-1.
BACKGROUND
The gonadotropin-releasing hormone (GnRH) stimulation test is time-consuming, invasive, and costly. However, it is the diagnostic gold standard for central precocious puberty (CPP), which in girls is defined as the onset of secondary sexual characteristics before the age of 8 years accompanied by breast buds, accelerated growth, and advanced bone age. This meta-analysis was performed to compare the diagnostic value of urinary gonadotropins and the GnRH stimulation test for CPP.
METHODS
We searched six databases for relevant literature. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we estimated the sensitivity, specificity, area under the summary receiver operating characteristic curve (AUC), and publication bias.
RESULTS
Six eligible trials fulfilled the inclusion criteria. In the meta-analysis of urinary luteinizing hormone (ULH), after excluding the data of one study, we obtained an AUC of 0.90 (sensitivity = 0.81, specificity = 0.85). The meta-analysis of the ULH to urinary follicle-stimulating hormone (UFSH) ratio revealed an AUC of 0.8116 (sensitivity = 0.79, specificity = 0.84).
CONCLUSION
Both the ULH level and ULH:UFSH ratio are effective and available approaches for CPP diagnosis.
TRIAL REGISTRATION
INPLASY 2021120076 .
背景
促性腺激素释放激素（GnRH）刺激试验既耗时、又具侵袭性，且费用高昂。然而，该试验是中枢性性早熟（CPP）的诊断金标准，CPP 定义为女孩在 8 岁之前出现第二性征，伴有乳腺芽、生长加速和骨龄提前。本荟萃分析旨在比较尿促性腺激素和 GnRH 刺激试验对 CPP 的诊断价值。
方法
我们检索了六个数据库的相关文献。根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，我们估计了敏感性、特异性、汇总受试者工作特征曲线下面积（AUC）和发表偏倚。
结果
符合纳入标准的六项试验均纳入荟萃分析。在黄体生成素（LH）尿分析的荟萃分析中，排除一项研究的数据后，我们获得了 AUC 为 0.90（敏感性=0.81，特异性=0.85）。LH 与卵泡刺激素（FSH）比值尿分析的荟萃分析显示 AUC 为 0.8116（敏感性=0.79，特异性=0.84）。
结论
LH 水平和 LH: FSH 比值均为 CPP 诊断的有效且可用的方法。
试验注册
INPLASY 2021120076 。
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