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Analysis of gonadotropin-releasing hormone (GnRH) test results in girls with precocious puberty

Korean Journal of Pediatrics 2009;52(12):1377-1382.
Published online December 15, 2009.
Analysis of gonadotropin-releasing hormone (GnRH) test results in girls with precocious puberty
Jung Yun Choi, Hyun-Ju Kang, Won Kyoung Cho, Kyoung Soon Kim, So Hyun Park, Seung Hoon Hahn, Min Ho Jung, Byung Kyu Suh, Byung Churl Lee
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
성조숙증 여아에서 생식샘자극호르몬분비호르몬 검사 결과의 분석
최정윤, 강현주, 조원경, 조경순, 박소현, 한승훈, 정민호, 서병규, 이병철
가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Min Ho Jung, Email: jmhpe@catholic.ac.kr
Abstract
Purpose
: The gonadotropin-releasing hormone (GnRH) test results of girls with precocious puberty were analyzed to determine whether this test can efficiently and clearly differentiate between central precocious puberty (CPP) and other disorders.
Methods
: Clinical and laboratory data of 54 girls with precocious pubertal signs were reviewed. Intravenous GnRH test was performed with blood samples obtained at 0, 30, 60, and 90 minutes. A peak luteinizing hormone (LH) level of ≥5.0 IU/L was indicative of CPP.
Results
: Of the 40 girls with CPP, 36 (90.0%), 3 (7.5%), and 1 (2.5%) showed peak LH levels at 30, 60, and 90 minutes, respectively. A percentage of girls whose peak LH ≥5.0 IU/L up to 30, 60, and 90 minutes was 92.5%, 100%, and 100%, respectively. The peak LH/follicle stimulating hormone (FSH) ratio of girls with CPP was 0.89±0.49 and was <1 in 16 of the 40 girls (40.0%). Girls with peak LH/FSH ratio of >1.0 showed higher chronological age (CA) (8.3±0.6 vs. 7.7±1.0 years, P=0.033), bone age (BA) (10.9±0.8 vs. 9.7±1.1 years, P=0.001), and BA-CA difference (2.6±0.7 vs. 2.0±0.7 years, P=0.009) than those of girls with peak LH/FSH ratio of ≤1.0. Higher percentage of girls with peak LH/FSH ratio of >1.0 showed advanced breast development (≥Tanner III) (93.7% vs. 41.7%, P=0.001).
Conclusion
: LH levels after 30 and 60 minutes of intravenous GnRH administration are the most useful for diagnosing CPP in girls.
Key Words: Precocious puberty, Gonadotropin-releasing hormone test


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