Factors to predict positive results of gonadotropin releasing hormone stimulation test in girls with suspected precocious puberty.
Sometimes, the clinical findings and the results of the gonadotropin-releasing hormone (GnRH) stimulation test are inconsistent in girls with early breast development and bone age advancement. We aimed to investigate the factors predicting positive results of the GnRH stimulation test in girls with suspected central precocious puberty (CPP). We reviewed the records of 574 girls who developed breast budding before the age of 8 yr and underwent the GnRH stimulation test under the age of 9 yr. Positive results of the GnRH stimulated peak luteinizing hormone (LH) level were defined as 5 IU/L and over. Girls with the initial positive results (n = 375) showed accelerated growth, advanced bone age and higher serum basal LH, follicle-stimulating hormone, and estradiol levels, compared to those with the initial negative results (n = 199). Girls with the follow-up positive results (n = 64) showed accelerated growth and advanced bone age, compared to those with the follow-up negative results. In the binary logistic regression, the growth velocity ratio was the most significant predictive factor of positive results. We suggest that the rapid growth velocity is the most useful predictive factor for positive results in the GnRH stimulation test in girls with suspected precocious puberty.
Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea.
Hyo-Kyoung
HK
Nam
Young Jun
YJ
Rhie
Chang Sung
CS
Son
Sang Hee
SH
Park
Kee-Hyoung
KH
Lee
D000365:Age Determination by Skeleton; D001940:Breast / Q000254:growth & development; D002648:Child; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000032:analysis*; D006801:Humans; D016015:Logistic Models; D007986:Luteinizing Hormone / Q000097:blood; D011237:Predictive Value of Tests; D011629:Puberty, Precocious / Q000175:diagnosis*; D012372:ROC Curve; D012189:Retrospective Studies
D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone