内科学
内分泌学
医学
促性腺激素
性早熟
催乳素
背景(考古学)
促性腺激素释放激素
人绒毛膜促性腺激素
激素
促黄体激素
睾酮(贴片)
早晨
泌尿系统
促卵泡激素
生物
古生物学
作者
Shumin Zhan,Ke Huang,Wei Wu,Danni Zhang,Ana Liu,Robert M. Dorazio,Jianrong Shi,Rahim Ullah,Li Zhang,Jinling Wang,Guanping Dong,Yan Ni,Junfen Fu
标识
DOI:10.1210/clinem/dgab448
摘要
Abstract Context Although gonadotropin-releasing hormone stimulation test (GnRHST) is the gold standard in diagnosing central precocious puberty (CPP), it is invasive, expensive, and time-consuming, requiring multiple blood samples to measure gonadotropin levels. Objective We evaluated whether urinary hormones could be potential biomarkers for prepuberty or postpuberty, aiming to simplify the current diagnosis and prognosis procedure. Methods We performed a cross-sectional study of a total of 355 girls with CPP in National Clinical Research Center for Child Health in China, including 258 girls with positive and 97 girls with negative results from GnRHST. Twenty patients received GnRH analogue (GnRHa) treatment and completed a 6-month follow up. We measured luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, progesterone, testosterone, and human chorionic gonadotropin in the first morning voided urine samples. Results Their urinary LH levels and the ratios of LH to FSH increased significantly with the advancement in Tanner stages. uLH levels were positively associated with basal and peak LH levels in the serum after GnRH stimulation. A cutoff value of 1.74 IU/L for uLH reached a sensitivity of 69.4% and a specificity of 75.3% in predicting a positive GnRHST result. For the combined threshold (uLH ≥ 1.74 + uLH-to-uFSH ratio > 0.4), the specificity reached 86.6%. After 3 months of GnRHa therapy, the uLH and uFSH levels decreased accordingly. Conclusion uLH could be a reliable biomarker for initial CPP diagnosis and screening; uLH could also be an effective marker for evaluating the efficacy of clinical treatment.
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