Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls.

BACKGROUND

Changes in pharmacological agents and advancements in laboratory assays have changed the gonadotropin-releasing hormone analog stimulation test.

OBJECTIVE

To determine the best predictive model for detecting puberty in girls.

SUBJECTS: Thirty-five girls, aged 2 years 7 months to 9 years 3 months, with central precocious puberty (CPP) (n=20) or premature thelarche/premature adrenarche (n=15).

METHODS

Diagnoses were based on clinical information, baseline hormones, bone age, and pelvic sonogram. Gonadotropins and E2 were analyzed using immunochemiluminometric assay. Logistic regression for CPP was performed.

RESULTS

The best predictor of CPP is the E2-change model based on 3- to 24-h values, providing 80% sensitivity and 87% specificity. Three-hour luteinizing hormone (LH) provided 75% sensitivity and 87% specificity. Basal LH lowered sensitivity to 65% and specificity to 53%.

CONCLUSIONS

The E2-change model provided the best predictive power; however, 3-h LH was more practical and convenient when evaluating puberty in girls.