Efficacy of morning serum LH combined with IGF-1 on pubertal initiation in children
10.16835/j.cnki.1000-9817.2022.09.025
- VernacularTitle:晨血促黄体生成素联合胰岛素样生长因子1 对儿童青春期启动的筛查效能
- Author:
LIU Hua, ZHANG Mengying, SONG Qing
1
Author Information
1. Department of Child Health Care, Wuhan Childrens Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan (430016) , China
- Publication Type:期刊文章
- Keywords:
Blood;
Luteinizing kormone;
Insulin like growth factor 1;
Puberty;
Growth and development;
Child
- From:
Chinese Journal of School Health
2022;43(9):1383-1387
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the screening cut off point and screening efficacy of morning serum LH combined with IGF-1 levels on puberty initiation to provide the basis for developing the gnrh stimulation test reasonably and promoting the systematic management of children and adolescence.
Methods:A retrospective study was conducted to select 1 724 children aged 8-13 years who took physical examination and were identified of breast development (between grade 2 and grade 3) or increased testicular volume (4.00-10.00 mL) in Child Health Department of Wuhan Children s Hospital during January 1st 2019 and December 31th 2021, and gonadotropin releasing hormone (GnRH) stimulation test was performed in endocrinology department ward in the same period. Doppler ultrasound was used to determine gonadal volume, and GnRH stimulation test was conducted to determine the puberty initiation in children. The ROC curve was utilized to determine the screening cut off points of morning serum LH and IGF-1 on puberty initiation, and the reliability and validity of the cut off points were all tested.
Results:The testicular volume was (4.88±2.19)mL in boys, and 75.5% was classified as initiation of gonadal growth. Whereas the ovaries volume was (1.78±0.65)mL in girls, and 91.39% classified as initiation of gonadal growth. The results of the GnRH stimulation test showed that among boys and girls, the medians LH peak were 13.22 and 21.79 IU/L, and the median LH/FSH peak ratios were 2.13 and 1.87. As a result, 597 boys and 864 girls were diagnosed as puberty initiation. Screening efficacy analysis indicated that the cut off point of morning serum LH on puberty initiation were 0.23 IU/L in male ( Kappa =0.60) and 0.22 IU/L in female ( Kappa =0.66), and IGF-1 cut off point were 187.00 IU/L in male( Kappa =0.45)and 178.00 IU/L in female ( Kappa =0.46). High sensitivity and specificity and better screening efficacy ( Kappa =0.60, 0.64) on single item screening of morning blood LH in boys and tandem screening of LH and IGF-1 in girls.
Conclusion:Morning serum LH and IGF-1 are good predictors on puberty initiation. GnRH stimulation test should be carried out to determine the puberty initiation when morning serum LH reaches 0.23 IU/L in boys, morning serum LH reaches 0.22 IU /L and IGF-1 reaches 178.00 IU/L in girls.
