Abstract：Objective To evaluate the diagnostic value of baseline serum luteinizing hormone (LH) level for central precocious puberty (CPP) in girls. Methods A total of 279 girls with precocious puberty were subjected to assessment of growth and development, bone age determination, baseline LH test, and follicle-stimulating hormone (FSH) test, gonadotropin-releasing hormone stimulation test, and other related examinations. Of the 279 patients, 175 were diagnosed with CPP and 104 with premature thelarche (PT). The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of baseline LH and FSH levels and their peak levels for CPP, and the correlation between the baseline LH level and the peak LH level was analyzed. Results The CPP group had signifcantly higher bone age, baseline LH and FSH levels, peak LH and FSH levels, and ratio of peak LH level to peak FSH level than the PT group (P < 0.01). The ROC curve proved that baseline LH level and peak LH level had good diagnostic values for CPP. Among the three bone age subgroups in the CPP group (7.0-9.0 years, 9.0-11.0 years, and > 11.0 years), baseline LH level showed the best diagnostic value in the > 11.0 years subgroup, with the largest area under the ROC curve. At a baseline LH level of 0.45 IU/L, the Youden index reached the peak value, and the sensitivity and specifcity were 66.7% and 80% respectively, for the diagnosis of CPP. At a peak LH level of 9.935 IU/L, the Youden index reached the peak value, and the sensitivity and specifcity were 74.8% and 100% respectively, for the diagnosis of CPP. The baseline LH level was positively correlated with the peak LH level (r=0.440, P < 0.01). Conclusions Baseline LH level can be used as an primary screening index for the diagnosis of CPP. It has a certain diagnostic value for CPP at different bone ages, and may be used as a monitoring index during the treatment and follow-up.
OU-YANG Li-Xue,YANG Fan. Diagnostic value of baseline serum luteinizing hormone level for central precocious puberty in girls[J]. CJCP, 2017, 19(7): 729-733.
Junqueira FR, Lara LA, Martins WP, et al. Gonadotropin and estradiol levels after leuprolide stimulation tests in Brazilian girls with precocious puberty[J]. J Pediatr Adolesc Gynecol, 2014, 28(5):313-316.
[8]
Uçar A, Saka N, Baş F, et al. Is premature thelarche in the frst two years of life transient[J]. J Clin Res Pediatr Endocrinol, 2012, 4(3):140-145.
[9]
Neely EK, Wilson DM, Lee PA, et al. Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty[J]. J Pediatr, 1995, 127(1):47-52.
[10]
Lee HS, Park HK, Ko JH, et al. Utility of basal luteinizing hormone levels for detecting central precocious puberty in girls[J]. Horm Metab Res, 2012, 44(11):851-854.
[11]
Harrington J, Palmert MR, Hamilton J. Use of local data to enhance uptake of published recommendations:an example from the diagnostic evaluation of precocious puberty[J]. Arch Dis Child, 2014, 99(1):15-20.
Carel JC, Eugster EA, Rogol A, et al. Consensus statement on the use of gonadotropin-releasing hormone analogs in children[J]. Pediatrics, 2009, 123(4):752-762.
