OBJECTIVETo investigate the relationship of plasma ghrelin and adenohypophyseal hormone levels in female precocious puberty.

METHODSA total of 84 patients aged from 6 to 9 years were enrolled in this study. They were divided into idiopathic central precocious puberty (ICPP) and premature thelarche(PT)groups according to their secondary sexual characteristics, bone age, volumes of uterus and ovary, and results of GnRH test. Plasma ghrelin levels were measured by radioimmunoassay. ACTH, TSH, PRL, GH, LH and FSH were measured by chemoluminescence technique.

RESULTSGhrelin levels in ICPP group were Log (2.42+/-0.26) ng/L, which were significantly lower than those in PT group and controls [Log (2.62+/-0.21) ng/L and Log (2.58+/-0.44) ng/L, respectively, P<0.05]. However there was no significant difference between PT group and controls(P>0.05). Ghrelin levels of ICPP girls with Tanner III were Log (2.31+/-0.24) ng/L, significantly lower than those of ICPP girls with Tanner II [Log (2.53+/-0.24) ng/L, P<0.05]. By bivariate correlation analysis, ghrelin levels in precocious puberty girls were negatively correlated with ACTH, PRL and LH15, LH30 and LH60 in GnRH test(r=-0.248, -0.235, -0.445, 0.405, 0.398, respectively, P<0.05). No significant correlation was found between ghrelin and GH, LH0(-2), FSH0(-2), and FSH15, FSH30 and FSH60 in GnRH test.

CONCLUSIONICPP girls have lower plasma ghrelin levels, which are decreased with the development of Tanner stage. The plasma ghrelin levels are negatively correlated with ACTH, PRL and LH.

Adrenocorticotropic Hormone ; blood ; Child ; Female ; Ghrelin ; blood ; Gonadotropins, Pituitary ; blood ; Humans ; Luteinizing Hormone ; blood ; Puberty, Precocious ; blood

OBJECTIVETo study the effects of valproate sodium (VPA) on the level and axle of pituitary gonadotropin in adolescent girls with epilepsy.

METHODSTwenty-three adolescent girls with epilepsy aged from 8 to 14 years were treated with VPA for 1 year. The levels of serum pituitary gonadotropin including estradiol, follicle-stimulating hormone, luteinizing hormone, prolactin and testosterone were measured before treatment and 3 months, 6 months and 1 year after treatment.

RESULTSThe serum levels of estradiol, follicle-stimulating hormone, luteinizing hormone and prolactin in the children with epilepsy were not significantly different during the 1 year VPA treatment compared with pretreatment. However, the serum level of testosterone was reduced 1 year after treatment (0.4±0.3 ng/mL) compared with pretreatment (0.7±0.4 ng/mL) and 3 months after treatment (0.7±0.4 ng/mL) (P<0.05).

CONCLUSIONSVPA treatment for 1 year does not increase serum levels of androgen in adolescent girls with epilepsy, suggesting that VPA is an ideal choice of treatment for the girls.

Adolescent ; Anticonvulsants ; therapeutic use ; Child ; Epilepsy ; blood ; drug therapy ; Female ; Gonadotropins, Pituitary ; blood ; Humans ; Valproic Acid ; therapeutic use

Serum levels of LH, FSH and prolactin and plasma levels of estradiol and progesterone were measured by radioimmunoassay from 8 healthy volunteers on no medication for at least 3 months prior to study and with histories of regular menstrual cycle. The following criteria were used to define a normal menstrual cycle:1) mid-cycle LH surge, 2) luteal phase duration between 12 and 16 days, 3) plasma progesterone levels above 5 ng/m1 5-10 days after LH surge. Six of eight cycles studied were considered normal. Serum levels of LH from 6 women were fair1y constant through the cycle, except at midcycle, when a surge occurred. The rapid increase of LH secretion was during the late follicular phase with a mean peak value of 147.5 mIU/ml. Concentration of FSH started to rise after the onset of menses and decreased slight1y during the late follicular phase. FSH rose sharply at midcycle with a mean peak value reaching 36.8 mIU/ml. Following the midcycle FSH and LH surge, FSH and LH decreased sharply and remained at lower concentration during the luteal phase than during the follicular phase. Serum prolactin concentrations fluctuated throughout the menstrual cycle. There was no peak value of prolactin concomitant to the LH peak. Plasma estradiol gradually increased during the follicular phase reaching a maximum of 354.3 pg/ml prior the midcycle LH surge. Following its peak, the level of estradiol dropped sharply and started to increase from the 3rd day after LH peak, rising to 235.9 pg/ml during the midluteal peak. Plasma progesterone levels remained consistently low during the follicular phase and started to rise after the midcycle surge of LH. This rise persisted from day 5 to day 9 after the LH surge, showing a mean value of 26.1 ng/m1. Afterward, a sharp decline occurred resulting in menstruation. Two cycles studied were considered abnormal. Both cycles showed a "short luteal phase".
Estradiol/blood ; Female ; Follicle Stimulating Hormone/blood ; Gonadotropins, Pituitary/blood* ; Human ; Korea ; Luteinizing Hormone/blood ; Menstruation* ; Progesterone/blood ; Prolactin/blood ; Sex Hormones/blood*

BACKGROUNDDelayed puberty can result either from constitutional delay of growth and puberty (CDP) or idiopathic hypogonadotropic hypogonadism (IHH). Gonadotropin-releasing hormone (GnRH) stimulation test has been generally accepted as a current method for diagnosing delayed puberty. The objective of this research was to assess the cut-off values and the efficacy of GnRH stimulation test in the diagnosis of delayed puberty in both males and females.

METHODSA study of 91 IHH, 27 CDP patients, 6 prepubertal children, and 20 pubertal adults was undertaken. Blood samples were obtained at 0, 30, 60, and 120 min after GnRH administration and the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured. For each parameter, the sensitivities and specificities were estimated, and the receiver operating characteristic (ROC) curves were constructed.

RESULTSThe ROC curves indicated that a serum basal LH <0.6 IU/L or peak LH <9.74 IU/L resulted in moderate sensitivity (73.8% or 80.0%) and specificity (90.9% or 86.4%) in the diagnosis of HH in males. Serum basal LH <0.85 IU/L or basal FSH <2.43 IU/L resulted in moderate sensitivity (80.0% or 100.0%) and specificity (75.0% or 50.0%) in the diagnosis of HH in females.

CONCLUSIONSOur data suggest that isolated use of the gonadorelin stimulation test is almost sufficient to discriminate between HH and CDP in males, but unnecessary in females. The most useful predictor is serum basal or peak LH to differentiate these two disorders in males, but serum basal LH or FSH in females.

Adolescent ; Female ; Follicle Stimulating Hormone ; blood ; Gonadotropin-Releasing Hormone ; pharmacology ; Gonadotropins ; deficiency ; Humans ; Hypogonadism ; blood ; diagnosis ; Hypothalamus ; drug effects ; Luteinizing Hormone ; blood ; Male ; Pituitary Gland ; drug effects ; Puberty, Delayed ; blood ; diagnosis ; Sensitivity and Specificity

Pulsatile gonadotropin-releasing hormone (GnRH) may induce spermatogenesis in most patients with congenital hypogonadotropic hypogonadism (CHH) by stimulating gonadotropin production, while the predictors for a pituitary response to pulsatile GnRH therapy were rarely investigated. Therefore, the aim of our study is to investigate predictors of the pituitary response to pulsatile GnRH therapy. This retrospective cohort study included 82 CHH patients who received subcutaneous pulsatile GnRH therapy for at least 1 month. Patients were categorized into poor or normal luteinizing hormone (LH) response subgroups according to their LH level (LH <2 IU l^-1 or LH ≥2 IU l^-1) 1 month into pulsatile GnRH therapy. Gonadotropin and testosterone levels, testicular size, and sperm count were compared between the two subgroups before and after GnRH therapy. Among all patients, LH increased from 0.4 ± 0.5 IU l^-1 to 7.5 ± 4.4 IU l^-1 and follicle-stimulating hormone (FSH) increased from 1.1 ± 0.9 IU l^-1 to 8.8 ± 5.3 IU l^-1. A Cox regression analysis showed that basal testosterone level (β = 0.252, P = 0.029) and triptorelin-stimulated FSH_60min(β = 0.518, P = 0.01) were two favorable predictors for pituitary response to GnRH therapy. Nine patients (9/82, 11.0%) with low LH response to GnRH therapy were classified into the poor LH response subgroup. After pulsatile GnRH therapy, total serum testosterone level was 39 ± 28 ng dl^-1 versus 248 ± 158 ng dl^-1 (P = 0.001), and testicular size was 4.0 ± 3.1 ml versus 7.9 ± 4.5 ml (P = 0.005) in the poor and normal LH response subgroups, respectively. It is concluded that higher levels of triptorelin-stimulated FSH_60minand basal total serum testosterone are favorable predictors of pituitary LH response to GnRH therapy.
Adult ; Cohort Studies ; Follicle Stimulating Hormone/blood* ; Gonadotropin-Releasing Hormone/therapeutic use* ; Gonadotropins/blood* ; History, 16th Century ; Humans ; Hypogonadism/pathology* ; Luteinizing Hormone/blood* ; Male ; Pituitary Gland/pathology* ; Predictive Value of Tests ; Retrospective Studies ; Sperm Count ; Testis/pathology* ; Testosterone/blood* ; Treatment Outcome ; Triptorelin Pamoate/therapeutic use* ; Young Adult