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Horm Metab Res 2014; 46(13): 959-963
DOI: 10.1055/s-0034-1387790
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

The Usefulness of the Leuprolide Stimulation Test as a Diagnostic Method of Idiopathic Central Precocious Puberty in Girls

F. Carretto
1   Endocrinologia Pediàtrica, Servei Pediatria, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
,
I. Salinas-Vert
2   Servei Endocrinologia i Nutrició, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
,
M. L. Granada-Yvern
3   Laboratori Hormonal, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
,
M. Murillo-Vallés
1   Endocrinologia Pediàtrica, Servei Pediatria, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
,
C. Gómez-Gómez
3   Laboratori Hormonal, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
,
M. Puig-Domingo
2   Servei Endocrinologia i Nutrició, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
,
J. Bel
1   Endocrinologia Pediàtrica, Servei Pediatria, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
› Author Affiliations
Further Information

Publication History

received 17 February 2014

accepted 06 August 2014

Publication Date:
08 October 2014 (online)

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Abstract

Central precocious puberty (CPP) diagnosis is based on clinical evaluation, but hormonal evaluation is crucial. The aim of the study was to evaluate the usefulness of the leuprolide stimulation test for diagnosis of idiopathic CPP. Sixty-one girls, aged 5–8 years, were evaluated retrospectively for premature breast development. According to clinical evolution, 28 had progressive puberty and 33 nonprogressive puberty. All underwent a leuprolide stimulation test. Cutoff points, sensitivity, and specificity for gonadotropins and estradiol were determined by receiver operating characteristic (ROC) curves. Cutoff points for CPP were: baseline LH: > 0.1 mUI/l, FSH: > 2.3 mUI/l, LH/FSH ratio: > 0.23, estradiol: > 12 pg/ml; and stimulated LH: > 5.5 mUI/l, LH/FSH ratio: > 0.24, estradiol: > 79.67 pg/ml. The best diagnostic efficiency for progressive puberty were stimulated LH/FSH ratio (sensitivity: 100%, specificity 94%) followed by stimulated LH (sensitivity: 93%, specificity: 100%). Stimulated LH/FSH ratio and LH resulted in the most useful parameters for the diagnosis of CPP. Stimulated estradiol did not add more information.

Key words

central precocious puberty - leuprolide stimulation test - stimulated gonadotropin ratio
 

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