Original articles

The quantitative measurement of morning voided urinary gonadotropin in diagnosis of rapidly progressive central precocious puberty in prepubertal girls

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  • Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2019-03-19

  Online published: 2022-07-14

Abstract

Objective: To explore a approach of differentiating rapidly progressive central precocious puberty (RP-CPP) from slowly progressive central precocious puberty(SP-CPP) in girls. Methods: Girls showing breast development before 8-year-old were enrolled. On the first visit, the lutropin hormone(LH) and follicle-stimulating hormone(FSH) in serum were quantitatively detected by lutropin hormone releasing hormone(LHRH) stimulating test, LH and FSH in urine were tested by quantitative determination Kits. Among enrolled girls, fifty-three were diagnosed as central precocious puberty (CPP). The patients were divided into SP-CPP (30 girls) and RP-CPP (23 girls) groups after 6 month-follow-up for pubertal advancement, height acceleration, and bone age maturation. The levels of LH and FSH in serum and urine as well as related parameters were compared between RP-CPP and SP-CPP groups. Results: Serum LH peak, the ratio of LH peak/FSH peak (the ratio of LH/FSH peak) and urinary FSH(UFSH) level showed reference value in differentiating RP-CPP from SP-CPP, While morning urinary LH (ULH) and urinary FH/FSH ratio were not different between RP-CPP and SP-CPP girls. Compared with SP-CPP subjects, RP-PP ones had significantly increased serum LH peak [(18.06±3.68) IU/L vs. (7.58±2.50) IU/L, P<0.001] and serum LH/FSH peak ratio(1.67±1.08 vs. 0.97±0.43, P=0.014) and decreased UFSH[(4.34±1.52) IU/L vs. 7.60±1.20)IU/L, P=0.007]. The diagnostic efficacy of indices mentioned above were assessed with receiver operator characteristic (ROC) curve. It showed that the sensitivity and specificity of serum LH peak (cutoff 9.68 IU/L) for differentiating RP-CPP from SP-CPP were 76.9% and 87.0% respectively, and serum LH/FSH peak ratio (cutoff value 1.24) were 69.2% and 73.9%. Morning UFSH (cutoff value 5.91 IU/L)for prospectively diagnosing RP-CPP had a sensitivity of 76.9% and a specificity of 78.3%, which had similar efficacy as serum LH peak and serum LH/FSH peak ratio. Conclusions: Quantitative measurement of morning voided urinary gonadotropin is a noninvasive and reliable approach to diagnose RP-CPP prospectively, and UFSH measurement on the first visit has reference value in prospective diagnosis.

Cite this article

MA Xiaoyu, YANG Yuanyan, LU Wenli, NI Jihong, WANG Junqi, CHEN Ye, QIN Xueyan, DONG Zhiya, WANG Wei . The quantitative measurement of morning voided urinary gonadotropin in diagnosis of rapidly progressive central precocious puberty in prepubertal girls[J]. Journal of Diagnostics Concepts & Practice, 2020 , 19(05) : 516 -520 . DOI: 10.16150/j.1671-2870.2020.05.013

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