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[基础促黄体生成素水平联合子宫容积测量在不同坦纳分期女童中枢性性早熟早期诊断中的价值]

[Value of basal luteinizing hormone level combined with uterine volume measurement in the early diagnosis of central precocious puberty in girls with different Tanner stages].

作者信息

Wang Wei, Cao Niu-Niu, Xiao Ya, Wang Yan, Wang Yi-Fan, Sun Jun

机构信息

Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University/Henan Maternal and Child Health Hospital, Zhengzhou 450052, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2023 Feb 15;25(2):159-165. doi: 10.7499/j.issn.1008-8830.2208204.

Abstract

OBJECTIVES

To study the value of basal luteinizing hormone (LH) level combined with uterine volume measurement in the early diagnosis of central precocious puberty (CPP) in girls with different Tanner stages.

METHODS

A retrospective analysis was performed on the girls who presented with breast development before the age of 8 years and attended the Third Affiliated Hospital of Zhengzhou University from January 2017 to September 2022. According to the results of gonadotropin-releasing hormone (GnRH) agonist test, the girls with peak LH ≥5.0 IU/L and peak LH/follicle stimulating hormone ≥0.6 were enrolled as the positive group, and the other girls were enrolled as the negative group. The two groups were compared in terms of the basal LH level and uterine volume. The receiver operating characteristic (ROC) curve was used to analyze their value in the early diagnosis of CPP.

RESULTS

For the girls with Tanner B2 and B3 stages, the positive group had significantly higher basal LH level and uterine volume than the negative group (<0.05). The basal LH level had an optimal cut-off value of 0.325 IU/L and 0.505 IU/L respectively in the diagnosis of Tanner stage B2/B3 CPP, while uterine volume had an optimal cut-off value of 1.639 mL and 2.158 mL respectively. Basal LH level combined with uterine volume measurement had a significantly larger area under the ROC curve than uterine volume measurement alone (<0.001), but with no significant difference compared with that of basal LH level measurement alone (>0.05).

CONCLUSIONS

Basal LH level combined with uterine volume measurement is valuable in the early diagnosis of CPP in girls with different Tanner stages, which provides a basis and guiding significance for clinical diagnosis of CPP.

摘要

目的

探讨基础促黄体生成素(LH)水平联合子宫容积测量在不同坦纳分期女童中枢性性早熟(CPP)早期诊断中的价值。

方法

对2017年1月至2022年9月在郑州大学第三附属医院就诊的8岁前出现乳房发育的女童进行回顾性分析。根据促性腺激素释放激素(GnRH)激动剂试验结果,将LH峰值≥5.0 IU/L且LH峰值/卵泡刺激素≥0.6的女童纳入阳性组,其余女童纳入阴性组。比较两组的基础LH水平和子宫容积。采用受试者操作特征(ROC)曲线分析其在CPP早期诊断中的价值。

结果

对于坦纳B2和B3期女童,阳性组的基础LH水平和子宫容积显著高于阴性组(<0.05)。基础LH水平在诊断坦纳B2/B3期CPP时的最佳截断值分别为0.325 IU/L和0.505 IU/L,而子宫容积的最佳截断值分别为1.639 mL和2.158 mL。基础LH水平联合子宫容积测量的ROC曲线下面积显著大于单独测量子宫容积(<0.001),但与单独测量基础LH水平相比无显著差异(>0.05)。

结论

基础LH水平联合子宫容积测量在不同坦纳分期女童CPP的早期诊断中具有重要价值,为CPP的临床诊断提供了依据和指导意义。

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An Approach to the Evaluation and Management of the Obese Child With Early Puberty.肥胖儿童性早熟的评估与管理方法
J Endocr Soc. 2021 Nov 19;6(1):bvab173. doi: 10.1210/jendso/bvab173. eCollection 2022 Jan 1.
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Diagnostic evaluation of central precocious puberty in girls.女孩中枢性性早熟的诊断评估。
Pediatr Neonatol. 2021 Mar;62(2):187-194. doi: 10.1016/j.pedneo.2020.12.001. Epub 2020 Dec 11.

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