title: [Clinical values of single or repeated triptorelin stimulating test in the differential diagnosis between idiopathic hypogonadotropic hypogonadism and constitutional delayed puberty].
abstract: OBJECTIVE
  To investigate the values of single or repeated luteinizing hormone (LH) releasing hormone analogue (triptorelin) stimulating test in the differential diagnosis between idiopathic hypogonadotropic hypogonadism (IHH) and constitutional delayed puberty (CDP).
  
  
  METHODS
  Male patients (n = 133) without puberty onset after the age of 14 were recruited for triptorelin stimulating test and were followed up for 24 - 48 months until the diagnosis were confirmed: 86 were IHH and the other 47 were CDP. Repeated triptorelin stimulating tests were conducted in 9 IHH patients and 13 CDP patients one year after the first stimulating tests with an attempt to evaluate the dynamic change of hypothalamus-pituitary-testis axis function. The relationship between the final diagnosis and the peak LH value (LH(max)), and the changes of repeated LH(max) were investigated.
  
  
  RESULTS
  In the single triptorelin stimulating test, LH(max) was (1.9 +/- 1.2) U/L in IHH group, which was significantly lower than that in CDP group [(13.7 +/- 8.3) U/L] (P < 0.01); 75 IHH patients (87.2%) had a LH(max) lower than 4 U/L, while only 2 CDP patients (4.3%) had a LH(max) lower than 4 U/L. When LH(max) < 4U/L was used as a criteria for the diagnosis of IHH, the single triptorelin stimulating test had a sensitivity of 87.2%, a specificity of 95.7%, and a positive predictive value of 97.4%. The repeated triptorelin stimulating tests performed one year later showed that the LH(max) in the 9 IHH patients increased from (4.7 +/- 2.5) U/L to (5.1 +/- 3.3) U/L (P = 0.78), while that in the 13 CDP patients increased from (10.7 +/- 3.3) U/L to (24.5 +/- 5.7) U/L (P < 0.05).
  
  
  CONCLUSIONS
  A single triptorelin stimulating test is highly effective in differentiating IHH from CDP. For some patients without definitive diagnosis, a repeated triptorelin stimulating test performed one year later may provide more valuable information on the dynamic change of the hypothalamus-pituitary-testis axis function.
authors.affiliation: Department of Endocrinology, Key Laboratory of Ministry of Health, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
authors.forename: Jiang-Feng
authors.initials: JF
authors.lastname: Mao
authors.forename: Xue-Yan
authors.initials: XY
authors.lastname: Wu
authors.forename: Shuang-Yu
authors.initials: SY
authors.lastname: Lu
authors.forename: Min
authors.initials: M
authors.lastname: Nie
mesh_terms: D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007006:Hypogonadism / Q000175:diagnosis*; D008297:Male; D011628:Puberty, Delayed / Q000175:diagnosis*; D017329:Triptorelin Pamoate; D055815:Young Adult
chemical_list: D017329:Triptorelin Pamoate