title: Factors that predict a positive response on gonadotropin-releasing hormone stimulation test for diagnosing central precocious puberty in girls.
abstract: OBJECTIVE
  The rapid increase in the incidence of precocious puberty in Korea has clinical and social significance. Gonadotropin-releasing hormone (GnRH) stimulation test is required to diagnose central precocious puberty (CPP), however this test is expensive and time-consuming. This study aimed to identify factors that can predict a positive response to the GnRH stimulation test.
  
  
  METHODS
  Clinical and laboratory parameters, including basal serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol (E2), were measured in 540 girls with clinical signs of CPP.
  
  
  RESULTS
  Two hundred twenty-nine of 540 girls with suspected CPP had a peak serum LH level higher than 5 IU/L (the CPP group). The CPP group had advanced bone age (P<0.001), accelerated yearly growth rate (P<0.001), increased basal levels of LH (P=0.02), FSH (P<0.001), E2 (P=0.001), and insulin-like growth factor-I levels (P<0.001) compared to the non-CPP group. In contrast, body weight (P<0.001) and body mass index (P<0.001) were lower in the CPP group. Although basal LH was significantly elevated in the CPP group compared to the non-CPP group, there was considerable overlap between the 2 groups. Cutoff values of basal LH (0.22 IU/L) detected CPP with 87.8% sensitivity and 20.9% specificity.
  
  
  CONCLUSIONS
  No single parameter can predict a positive response on the GnRH stimulation test with both high sensitivity and specificity. Therefore, multiple factors should be considered in evaluation of sexual precocity when deciding the timing of the GnRH stimulation test.
authors.affiliation: Department of Pediatrics, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Junghwan
authors.initials: J
authors.lastname: Suh
authors.affiliation: Department of Pediatrics, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Myung Hyun
authors.initials: MH
authors.lastname: Choi
authors.affiliation: Department of Pediatrics, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ah Reum
authors.initials: AR
authors.lastname: Kwon
authors.affiliation: Department of Pediatrics, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ye Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Jeong
authors.affiliation: Department of Pediatrics, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Ahn
authors.affiliation: Department of Pediatrics, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyun Wook
authors.initials: HW
authors.lastname: Chae
authors.affiliation: Sowha Children's Hospital, Seoul, Korea.
authors.forename: Duk Hee
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Kim
keywords: Diagnosis; Female; Forecasting; Gonadotropin-releasing hormone; Precocious puberty