Min Sun Kim1,2, Pyoung Han Hwang1,2, Dae-Yeol Lee3,4. 1. Department of Pediatrics, Chonbuk National University Medical School, 634-18 Keumam-dong, Jeonju, 561-712, Korea. 2. Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Institute of Chonbuk National University Hospital, Jeonju, 561-712, Korea. 3. Department of Pediatrics, Chonbuk National University Medical School, 634-18 Keumam-dong, Jeonju, 561-712, Korea. leedy@jbnu.ac.kr. 4. Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Institute of Chonbuk National University Hospital, Jeonju, 561-712, Korea. leedy@jbnu.ac.kr.
Abstract
OBJECTIVE: To investigate and simplify the gonadotropin-releasing hormone (GnRH) stimulation test for assessing pubertal activation and suppression. METHODS: The authors identified 72 girls diagnosed with central precocious puberty who were treated with a GnRH analogue (GnRHa). Patients who underwent an assessment regarding GnRHa-mediated puberty suppression had been diagnosed via the GnRH stimulation test prior to GnRHa treatment. The authors analyzed the diagnostic values of the during/before-treatment LH levels at different time points by a receiver-operating characteristic (ROC) curve. RESULTS: Before GnRHa treatment, the mean luteinizing hormone (LH) level was higher at the 30-min test time point than at baseline or the 15, 60, 90, and 120-min points (P < 0.001). After GnRHa treatment, the LH levels were suppressed in 62 patients (86.1%) and inadequately suppressed in 10 (13.9%). The LH level was higher at the 30-min test time point than those at baseline or the 45 and 60-min level (P < 0.001). The area under the curve in a post-GnRHa treatment was greatest at 30 min. CONCLUSIONS: The simplified GnRH test is adequate for evaluating pubertal activation (30 and/or 45-min time points of the GnRH test) and suppression (the 30-min time point).
OBJECTIVE: To investigate and simplify the gonadotropin-releasing hormone (GnRH) stimulation test for assessing pubertal activation and suppression. METHODS: The authors identified 72 girls diagnosed with central precocious puberty who were treated with a GnRH analogue (GnRHa). Patients who underwent an assessment regarding GnRHa-mediated puberty suppression had been diagnosed via the GnRH stimulation test prior to GnRHa treatment. The authors analyzed the diagnostic values of the during/before-treatment LH levels at different time points by a receiver-operating characteristic (ROC) curve. RESULTS: Before GnRHa treatment, the mean luteinizing hormone (LH) level was higher at the 30-min test time point than at baseline or the 15, 60, 90, and 120-min points (P < 0.001). After GnRHa treatment, the LH levels were suppressed in 62 patients (86.1%) and inadequately suppressed in 10 (13.9%). The LH level was higher at the 30-min test time point than those at baseline or the 45 and 60-min level (P < 0.001). The area under the curve in a post-GnRHa treatment was greatest at 30 min. CONCLUSIONS: The simplified GnRH test is adequate for evaluating pubertal activation (30 and/or 45-min time points of the GnRH test) and suppression (the 30-min time point).
Authors: Jean-Claude Carel; Erica A Eugster; Alan Rogol; Lucia Ghizzoni; Mark R Palmert; Franco Antoniazzi; Sheri Berenbaum; Jean-Pierre Bourguignon; George P Chrousos; Joël Coste; Sheri Deal; Liat de Vries; Carol Foster; Sabine Heger; Jack Holland; Kirsi Jahnukainen; Anders Juul; Paul Kaplowitz; Najiba Lahlou; Mary M Lee; Peter Lee; Deborah P Merke; E Kirk Neely; Wilma Oostdijk; Moshe Phillip; Robert L Rosenfield; Dorothy Shulman; Dennis Styne; Maïthé Tauber; Jan M Wit Journal: Pediatrics Date: 2009-03-30 Impact factor: 7.124
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