Leuteinizing hormone responses to leuprolide acetate discriminate between hypogonadotropic hypogonadism and constitutional delay of puberty.
OBJECTIVE
To assess if leuprolide acetate stimulation discriminates between hypogonadotropic hypogonadism (HH) and constitutional delay of puberty (CDP) in males.


METHODS
Case-control study.


METHODS
Patients attending an academic research environment.


METHODS
Only male patients were studied: 10 with HH (group 1, age 16.5 +/- 6.0 years), 8 prepubertal with CDP (group 2, age 14.3 +/- 1.2 years), 6 healthy prepubertal (group 3, age 9.5 +/- 3.3 years), and 8 healthy late-pubertal (group 4, age 15.1 +/- 3.1 years).


METHODS
Blood samples were obtained after an overnight fast. Leuprolide acetate was then administered SC, and blood samples were drawn at 0, 30, 60, 120, 180 minutes, and 6 and 24 hours after stimulation.


METHODS
Clinical follow-up evaluations of data and serum levels of LH, FSH, 17-hydroxyprogesterone, and testosterone.


RESULTS
Basal LH levels were similar in groups 1 through 3 and differed significantly from those in group 4. Peak serum LH levels were significantly higher in CDP compared with HH (8.9 +/- 1.4 vs. 1.4 +/- 0.2 IU/L). Baseline FSH levels were significantly higher only in pubertal boys (versus the HH group); peak levels did not differ among the groups. Basal and peak testosterone levels were significantly higher only in the control pubertal group when compared to the other groups; peak 17-hydroxyprogesterone concentrations were significantly higher in pubertal controls compared with HH and CDP.


CONCLUSIONS
Peak LH responses clearly discriminate HH from CDP. Timing for blood sampling should be fixed at 0, 60, 120, 180 minutes after stimulation.
Street
Maria Elisabeth
ME
Department of Paediatrics, University of Parma, Parma, Italy.
Bandello
Maria Antonietta
MA
Terzi
Cesare
C
Ibañez
Lourdes
L
Ghizzoni
Lucia
L
Volta
Cecilia
C
Tripodi
Candida
C
Virdis
Raffaele
R
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D003937:Diagnosis, Differential; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000175:diagnosis* / Q000473:pathology; D016729:Leuprolide / Q000494:pharmacology; D007986:Luteinizing Hormone / Q000096:biosynthesis* / Q000097:blood; D008297:Male; D011628:Puberty, Delayed / Q000175:diagnosis* / Q000473:pathology; D012044:Regression Analysis; D013739:Testosterone / Q000097:blood
D013739:Testosterone; D019326:17-alpha-Hydroxyprogesterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide