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The Use of Morning Urinary Gonadotropins and Sex Hormones in the Management of Early Puberty in Chinese Girls.
- Source :
-
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2021 Oct 21; Vol. 106 (11), pp. e4520-e4530. - Publication Year :
- 2021
-
Abstract
- Context: Although gonadotropin-releasing hormone stimulation test (GnRHST) is the gold standard in diagnosing central precocious puberty (CPP), it is invasive, expensive, and time-consuming, requiring multiple blood samples to measure gonadotropin levels.<br />Objective: We evaluated whether urinary hormones could be potential biomarkers for prepuberty or postpuberty, aiming to simplify the current diagnosis and prognosis procedure.<br />Methods: We performed a cross-sectional study of a total of 355 girls with CPP in National Clinical Research Center for Child Health in China, including 258 girls with positive and 97 girls with negative results from GnRHST. Twenty patients received GnRH analogue (GnRHa) treatment and completed a 6-month follow up. We measured luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, progesterone, testosterone, and human chorionic gonadotropin in the first morning voided urine samples.<br />Results: Their urinary LH levels and the ratios of LH to FSH increased significantly with the advancement in Tanner stages. uLH levels were positively associated with basal and peak LH levels in the serum after GnRH stimulation. A cutoff value of 1.74 IU/L for uLH reached a sensitivity of 69.4% and a specificity of 75.3% in predicting a positive GnRHST result. For the combined threshold (uLH ≥ 1.74 + uLH-to-uFSH ratio > 0.4), the specificity reached 86.6%. After 3 months of GnRHa therapy, the uLH and uFSH levels decreased accordingly.<br />Conclusion: uLH could be a reliable biomarker for initial CPP diagnosis and screening; uLH could also be an effective marker for evaluating the efficacy of clinical treatment.<br /> (© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society.)
- Subjects :
- Biomarkers urine
Child
Child, Preschool
China
Cross-Sectional Studies
Estradiol urine
Female
Follicle Stimulating Hormone blood
Follicle Stimulating Hormone urine
Gonadotropin-Releasing Hormone analogs & derivatives
Humans
Leuprolide therapeutic use
Luteinizing Hormone blood
Luteinizing Hormone urine
Puberty
Puberty, Precocious drug therapy
ROC Curve
Triptorelin Pamoate therapeutic use
Gonadal Steroid Hormones urine
Gonadotropins urine
Puberty, Precocious urine
Subjects
Details
- Language :
- English
- ISSN :
- 1945-7197
- Volume :
- 106
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 34160619
- Full Text :
- https://doi.org/10.1210/clinem/dgab448