Analysis of the cut point of peak level of luteinizing hormone in gonadotropin-releasing hormone agonist test in obese girls with precocious puberty
10.3760/cma.j.issn.2095-428X.2019.08.008
- VernacularTitle:性早熟肥胖女童促性腺激素释放激素激发试验促黄体生成素峰值切点的分析
- Author:
Jianwei ZHANG
1
;
Ningning ZHAO
;
Wei PENG
;
Ke HUANG
;
Guanping DONG
;
Junfen FU
Author Information
1. 浙江大学医学院附属儿童医院内分泌科
- Keywords:
Body mass index;
Precocious puberty;
Gonadotropin-releasing hormone agonist test;
Receiver operating characteristic curve
- From:
Chinese Journal of Applied Clinical Pediatrics
2019;34(8):591-594
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the significance of the cut point of peak level of luteinizing hormone (LH) in gonadotropin-releasing hormone (GnRH) agonist test in the diagnosis of precocious puberty in obese girls.Methods According to the diagnostic criteria of children's central precocious puberty diagnosis consensus (2015),796 cases of precocious puberty (peak level of LH ≥3.3 IU/L) in Children's Hospital of Zhejiang University School of Medicine from January 2014 to December 2015 were divided into normal weight group (573 cases),overweight group (170 cases) and obesity group (53 cases).The 3 groups were compared in terms of basic level of LH,basic level of follicle stimulating hormone (FSH),peak level of LH and FSH,ratio of LH (peak)/FSH (peak),sex hormone binding protein (SHBG),and children with 3.3 IU/L ≤peak level of LH ＜5.0 IU/L were followed up.The accuracy of the diagnosis of central precocious puberty using peak level of LH was analyzed by using receiver operating characteristic (ROC) curve.Results The median of LH (peak) in the obese group was 6.92 IU/L,the median of SHBG was 46.52 nmol/L,the median of LH (peak) in normal weight group was 8.92 IU/L,and the median of SHBG was 87.28 nmol/L.There were significant differences between the 2 groups (P ＜ 0.05,0.001).A total of 89 cases in normal weight group and 65 cases of obesity/overweight group (3.3 IU/L ≤peak level of LH ＜5.0 IU/L) were followed up for 1 year,and 18 cases in normal weight group and 33 cases in obesity/overweight group developed to central precocious puberty,while the number of cases in the 2 groups was significantly different (P ＜0.001).The ROC curve analysis showed that the cut point of peak level of LH was 4.16 IU/L,the sensitivity was 0.606,the specificity was 0.656,and the Jordan index was the largest (0.344).Conclusions The peak level of LH in GnRH agonist test is important for the diagnosis of central precocious puberty in girls,but the effect of body mass index on its cut point needs to be considered.
