Background： Delayed puberty can result either from constitutional delay of growth and puberty （CDP） or idiopathic hypogonadotropic hypogonadism （IHH）. Gonadotropin-releasing hormone （GnRH） stimulation test has ...Background： Delayed puberty can result either from constitutional delay of growth and puberty （CDP） or idiopathic hypogonadotropic hypogonadism （IHH）. Gonadotropin-releasing hormone （GnRH） stimulation test has been generally accepted as a current method for diagnosing delayed puberty. The objective of this research was to assess the cut-offvalues and the efficacy of GnRH stimulation test in the diagnosis of delayed puberty in both males and females. Methods： A study of 91 IHH, 27 CDP patients, 6 prepubertal children, and 20 pubertal adults was undertaken. Blood samples were obtained at 0, 30, 60, and 120 rain after GnRH administration and the levels of luteinizing hormone （LH） and follicle-stimulating hormone （FSH） were rneast, red. For each paralneter, the sensitivities and specificities were estimated, and the receiver operating characteristic （ROC） curves were constructed. Resulis： The ROC curves indicated that a serunl basal LH 〈0.6 IU/L or peak LH 〈9.74 IU/L resulted in moderate sensitivity （73.8% or 80.0%） and specificity （90.9% or 86.4%） in the diagnosis of HH in males. Serum basal LH 〈0.85 IU/L or basal FSH 〈2.43 IU/L resulted in moderate sensitivity （80.0% or 100.0%） and specificity （75.0% or 50.0%） in the diagnosis of HH in females. Conclusions： Our data suggest that isolated use of the gonadorelin stimulation test is almost sufficient to discriminate between HH and CDP in males, but unnecessary in females. The most useful predictor is serum basal or peak LH to differentiate these two disorders in males, but serum basal LH or FSH in females.展开更多
体质性青春期发育延迟(constitutional delay of growth and puberty,CDGP)与先天性低促性腺激素性性腺功能减退(congenital hypogonadotropic hypogonadism,CHH)是两类导致青春期发育延迟的常见病因。两者在临床表现上具有较高的相似性...体质性青春期发育延迟(constitutional delay of growth and puberty,CDGP)与先天性低促性腺激素性性腺功能减退(congenital hypogonadotropic hypogonadism,CHH)是两类导致青春期发育延迟的常见病因。两者在临床表现上具有较高的相似性,均表现为缺乏正常青春期启动、血液循环中促性腺激素及性激素水平低下。尽管CDGP为一过性、自限性的青春期发育延迟,而CHH是持久性的性腺功能减退,但两者在成年期前较难准确鉴别。近年来的研究显示,微小青春期对于早期诊断CHH是一个非常重要的时间窗口。此外,抑制素B水平以及Kisspeptin兴奋试验可能在两者的鉴别诊断上具有较大的应用价值。展开更多
文摘Background： Delayed puberty can result either from constitutional delay of growth and puberty （CDP） or idiopathic hypogonadotropic hypogonadism （IHH）. Gonadotropin-releasing hormone （GnRH） stimulation test has been generally accepted as a current method for diagnosing delayed puberty. The objective of this research was to assess the cut-offvalues and the efficacy of GnRH stimulation test in the diagnosis of delayed puberty in both males and females. Methods： A study of 91 IHH, 27 CDP patients, 6 prepubertal children, and 20 pubertal adults was undertaken. Blood samples were obtained at 0, 30, 60, and 120 rain after GnRH administration and the levels of luteinizing hormone （LH） and follicle-stimulating hormone （FSH） were rneast, red. For each paralneter, the sensitivities and specificities were estimated, and the receiver operating characteristic （ROC） curves were constructed. Resulis： The ROC curves indicated that a serunl basal LH 〈0.6 IU/L or peak LH 〈9.74 IU/L resulted in moderate sensitivity （73.8% or 80.0%） and specificity （90.9% or 86.4%） in the diagnosis of HH in males. Serum basal LH 〈0.85 IU/L or basal FSH 〈2.43 IU/L resulted in moderate sensitivity （80.0% or 100.0%） and specificity （75.0% or 50.0%） in the diagnosis of HH in females. Conclusions： Our data suggest that isolated use of the gonadorelin stimulation test is almost sufficient to discriminate between HH and CDP in males, but unnecessary in females. The most useful predictor is serum basal or peak LH to differentiate these two disorders in males, but serum basal LH or FSH in females.
文摘体质性青春期发育延迟(constitutional delay of growth and puberty,CDGP)与先天性低促性腺激素性性腺功能减退(congenital hypogonadotropic hypogonadism,CHH)是两类导致青春期发育延迟的常见病因。两者在临床表现上具有较高的相似性,均表现为缺乏正常青春期启动、血液循环中促性腺激素及性激素水平低下。尽管CDGP为一过性、自限性的青春期发育延迟,而CHH是持久性的性腺功能减退,但两者在成年期前较难准确鉴别。近年来的研究显示,微小青春期对于早期诊断CHH是一个非常重要的时间窗口。此外,抑制素B水平以及Kisspeptin兴奋试验可能在两者的鉴别诊断上具有较大的应用价值。
