Jin Weimin, Zhang Miangen, Xiang Jun, Li Zhishu
Department of Pediatrics, The Third Affiliated Hospital of Wenzhou Medical University, 325200 Wenzhou, Zhejiang, China.
Department of Chinese Pediatrics, The Third Affiliated Hospital of Wenzhou Medical University, 325200 Wenzhou, Zhejiang, China.
Rev Int Androl. 2024 Dec;22(4):68-74. doi: 10.22514/j.androl.2024.032. Epub 2024 Dec 30.
This study aims to explore the diagnostic significance of basal sex hormone levels and pelvic B-mode ultrasound in the context of central precocious puberty (CPP) in female children.
A cohort study was conducted at the Third Affiliated Hospital of Wenzhou Medical University from January 2014 to January 2024. The study enrolled female children exhibiting early breast development before the age of 8 and subjected them to gonadotropin-releasing hormone (GnRH) stimulation tests. Subsequently, the participants were categorized into a CPP cohort and a non- CPP cohort, each comprising 75 individuals. Comparative analysis was performed on the basal luteinizing hormone (LH) levels, uterine length and ovarian volume between the two cohorts.
The results show no significant differences were observed in age and body mass index (BMI) between the CPP and non-CPP groups (both > 0.05). However, basal LH levels, uterine length, and ovarian volume were significantly higher in the CPP group compared to the non-CPP group (all < 0.05). Binary logistic regression analysis revealed that basal LH levels, uterine length, and ovarian volume were independent risk factors for CPP in female children (all < 0.05). Receiver Operating Characteristic (ROC) curve analysis showed that the area under the curve (AUC) for basal LH, ovarian volume, and uterine length were 0.823, 0.752 and 0.730, respectively. The combined diagnosis of these three factors significantly improved diagnostic performance, with an AUC of 0.931 (95% confidence interval (CI) : 0.891-0.972), a sensitivity of 88.00%, and a specificity of 86.70%.
The integration of basal levels of sex hormones and pelvic B-mode ultrasound holds considerable importance in the diagnosis of CPP in young girls, offering a non-invasive, accessible and cost-effective method for clinical assessment. Therefore, its utilization is highly recommended.
本研究旨在探讨基础性激素水平及盆腔B超在女童中枢性性早熟(CPP)诊断中的意义。
于2014年1月至2024年1月在温州医科大学附属第三医院开展队列研究。纳入8岁前出现乳房早发育的女童,对其进行促性腺激素释放激素(GnRH)激发试验。随后,将参与者分为CPP队列和非CPP队列,各75例。对两组的基础促黄体生成素(LH)水平、子宫长度和卵巢体积进行比较分析。
结果显示,CPP组和非CPP组在年龄和体重指数(BMI)方面均无显著差异(均>0.05)。然而,CPP组的基础LH水平、子宫长度和卵巢体积显著高于非CPP组(均<0.05)。二元logistic回归分析显示,基础LH水平、子宫长度和卵巢体积是女童CPP的独立危险因素(均<0.05)。受试者工作特征(ROC)曲线分析显示,基础LH、卵巢体积和子宫长度的曲线下面积(AUC)分别为0.823、0.752和0.730。这三个因素联合诊断显著提高了诊断性能,AUC为0.931(95%置信区间(CI):0.891 - 0.972),灵敏度为88.00%,特异度为86.70%。
性激素基础水平与盆腔B超相结合在幼女CPP诊断中具有重要意义,为临床评估提供了一种无创、便捷且经济有效的方法。因此,强烈推荐使用。