Auxological and Metabolic Parameters of Children Undergoing the Gonadotropin-Releasing Hormone Stimulation Test: Correlations with the Final Diagnosis of Central Precocious Puberty in a Single-Center Study
Abstract
:1. Introduction
2. Patients and Methods
2.1. Study Characteristics
2.2. Patient Selection
2.3. Characteristics of the GnRH Stimulation Test
2.4. Statistical Analysis
3. Results
3.1. Main Results
3.2. Multivariate Analysis
4. Discussion
5. Conclusive Remarks
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study Population (N = 37) | |
---|---|
Females, n (%) | 35 (94.6) |
Age (years) | 7.18 (2.38–7.72) |
Height (cm) | 124 (88.00–131.35) |
Z-score height | 0.5 (−1.33–1.18) |
Weight (kg) | 26.65 (15.67) |
Z-score weight | 0.42 (−1.41–1.34) |
BMI (kg/m2) | 16.89 (14.88–19.53) |
Z-score BMI | 0.3 (2.34) |
Adrenarche, n (%) | 5 (13.5) |
Familiar history of CPP, n (%) | 6 (16.2) |
TSH (mU/L) | 1.90 (1.35–4.41) |
fT3 (pg/mL) | 3.82 (1.39) |
fT4 (ng/dL) | 12.14 (1.68) |
Abnormal thyroid profile, n (%) | 10 (27.0) |
Glucose (mg/dL) | 76.59 (7.15) |
Hb (g/dL) | 12.99 (0.98) |
Platelet count (×109/L) | 317.51 (84.08) |
Abnormal blood count, n (%) | 6 (16.2) |
GOT (IU/L) Increased GOT, n (%) | 17 (14.00–19.50) 2 (5.4) |
Triglycerides (mg/dL) | 61 (48.5–73.5) |
Cholesterol (mg/dL) | 155.35 (25.13) |
LDL (mg/dL) | 89.11 (19.55) |
HDL (mg/dL) | 52.76 (13.40) |
Abnormal lipid profile, n (%) | 14 (37.8) |
FSH (IU/mL) | 3.4 (1.35–5.95) |
Increased baseline FSH, n (%) | 24 (64.9) |
LH (mIU/mL) | 0.1 (0.1–0.45) |
Increased baseline LH, n (%) | 5 (13.5) |
SHBG (nmol/L) | 87 (57.50–119.50) |
17BE2 (pg/mL) | 19.00 (15.00–28.00) |
Prolactin (ng/mL) | 7.6 (5.3–12.6) |
Increased prolactin, n (%) | 13 (35.1) |
Increased bone age ≥ 1, n (%) | 17 (45.9) |
Pathological MRI *, n (%) | 3 (8.3) |
Uterus length ≥ 3.6 cm **, n (%) | 6 (17.1) |
Uterus antero–posterior diameter > 1 cm **, n (%) | 6 (17.1) |
Uterine body/cervix ratio > 1, n (%) | 8 (22.9) |
Ovarian volume ≥ 2 mL, n (%) | 15 (42.9) |
LH peak | 3.4 (1.4–8.4) |
FSH peak | 14.40 (8.55–23.45) |
LH/FSH ratio | 0.11 (0.007–0.25) |
LH/FSH ratio > 1, n (%) | 7 (18.9) |
LH/FSH ratio > 0.6, n (%) | 7 (18.9) |
CPP, n (%) | 18 (48.6) |
CPP etiology #, n (%) Idiopathic Organic | |
16 (88.9) | |
2 (11.1) |
Non-PPC Group (N = 19) | PPC Group (N = 18) | p | |
---|---|---|---|
Female, n (%) | 17 (89.5) | 18 (100) | 0.49 |
Age (years), median (IQR) | 7.32 (5.7–7.8) | 7.02 (1.3–7.7) | 0.37 |
Height (cm), median (IQR) | 127.2 (110.0–133.0) | 123.0 (76.5–130.3) | 0.28 |
Z-score height, median (IQR) | 0.5 (−2.1–1.3) | 0.26 (−0.96–1.04) | 0.73 |
Weight (kg), median (IQR) | 30.0 (15.0–40.0) | 24.5 (9.4–30.4) | 0.13 |
Z-score weight, median (IQR) | 1.05 (−1.1–1.81) | 0.4 (−1.9–1.1) | 0.27 |
BMI, median (IQR) | 17.5 (13.5–23.3) | 16.7 (15.1–18.2) | 0.40 |
Z-score BMI, mean (+/−SD) | 0.70 (+/−1.5) | −0.007 (+/−1.26) | 0.13 |
Adrenarche, n (%) | 3 (15.8) | 2 (11.1) | 1 |
Familiar history of CPP, n (%) | 2 (10.5) | 4 (22.2) | 0.40 |
TSH, median (IQR) | 1.8 (1.6–5.4) | 1.95 (1.3–3.1) | 0.73 |
fT3, mean (+/−SD) | 3.7 (+/−1.3) | 3.98 (+/−1.5) | 0.5 |
fT4, mean (+/−SD) | 12.6 (+/−1.6) | 11.6 (+/−1.6) | 0.07 |
Abnormal thyroid profile, n (%) | 5 (26.3) | 5 (27.8) | 1 |
Glycemia (mg/dl), mean (+/−SD) | 78.2 (+/- 6.6) | 74.9 (+/−7.5) | 0.16 |
Hb, median (IQR) | 12.9 (12.5–13.6) | 13.0 (12.4–13.6) | 0.62 |
Platelet count, mean (+/−SD) | 324.8 (+/−91.5) | 309.8 (+/−77.4) | 0.59 |
Abnormal blood cell count, n (%) | 4 (21.1) | 2 (11.1) | 0.66 |
GOT, median (IQR) | 17.0 (14.0–20.0) | 16.0 (13.7–19.0) | 0.54 |
Increased GOT, n (%) | 1 (5.3) | 1 (5.6) | 1 |
Triglycerides, median (IQR) | 61.0 (45.0–75.0) | 60.0 (55.5–69.0) | 0.66 |
Cholesterol, mean (+/−SD) | 158.0 (+/−28.0) | 152.5 (+/−22.2) | 0.51 |
LDL, mean (+/−SD) | 90.16 (+/−22.82) | 88. 0 (+/−15.99) | 0.74 |
HDL, mean (+/−SD) | 53.11 (+/−14.11) | 52.3 (+/−13.01) | 0.87 |
Abnormal lipid profile, n (%) | 10 (52.6) | 4 (22.2) | 0.09 |
FSH, median (IQR) | 1.6 (1.0–3.4) | 5.5 (3.1–8.2) | <0.001 |
Increased baseline FSH, n (%) | 8 (42.1) | 16 (88.9) | 0.005 |
LH, median (IQR) | 0.1 (0.1–0.1) | 0.15 (0.1–1.5) | 0.03 |
Increased baseline LH, n (%) | 0 (0) | 5 (27.8) | 0.02 |
SHBG, median (IQR) | 65.0 (42.0–99.0) | 102.0 (75.2–128.5) | 0.02 |
17BE2, median (IQR) | 15.0 (15.0–20.0) | 23.0 (18.7–44.2) | 0.001 |
Prolactin, median (IQR) | 8.0 (5.3–15.0) | 7.5 (5.0–12.4) | 0.68 |
Increased prolactin, n (%) | 7 (36.8) | 6 (33.3) | 1 |
Advanced bone age ≥ 1 year, n (%) | 12 (63.2) | 8 (44.4) | 0.25 |
Pathological brain MRI, n (%) | 1 (5.3) | 2 (11.8) | 0.59 |
Uterus length ≥ 3.6 cm **, n (%) | 2 (11.8) | 4 (22.2) | 0.66 |
Uterus antero–posterior diameter > 1 cm **, n (%) | 2 (11.8) | 4 (22.2) | 0.66 |
Uterine body/cervix ratio > 1, n (%) | 3 (17.6) | 5 (27.8) | 0.69 |
Ovarian volume ≥ 2 mL, n (%) | 7 (41.2) | 8 (44.4) | 0.84 |
LH peak, median (IQR) | 1.4 (0.7–2.2) | 8.4 (6.7–26.8) | <0.001 |
FSH peak, median (IQR) | 10.5 (5.1–19.0) | 18.9 (10.2–44.6) | 0.01 |
LH/FSH ratio, median (IQR) | 0.008 (0.005–0.048) | 0.109 (0.01–0.76) | 0.006 |
LH/FSH ratio > 1, n (%) | 0 (0) | 7 (38.9) | 0.003 |
Variable | F-Test | p |
---|---|---|
fT4 | 2.247 | 0.101 |
Abnormal lipid profile | 1.590 | 0.210 |
FSH | 0.952 | 0.427 |
LH | 4.354 | 0.011 |
SHBG | 1.166 | 0.337 |
17BE2 | 4.968 | 0.006 |
LH peak | 5.425 | 0.004 |
FSH peak | 23.457 | <0.001 |
LH/FSH ratio | 4.801 | 0.007 |
Variable | Accuracy | 95%CI | p | Best Cut-off | Sensitivity (%) | Specificity (%) |
---|---|---|---|---|---|---|
LH | 0.708 | 0.536−0.879 | 0.031 | 0.15 | 50 | 90 |
17BE2 | 0.811 | 0.671–0.952 | 0.001 | 21.5 | 67 | 90 |
LH peak | 0.988 | 0.964–1.000 | 0.001 | 4.10 | 94 | 95 |
FSH peak | 0.744 | 0.586–0.902 | 0.010 | 21.5 | 44 | 90 |
LH/FSH | 0.762 | 0.603–0.907 | 0.007 | 0.023 | 72 | 74 |
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Cipolla, C.; Sodero, G.; Pane, L.C.; Mariani, F.; Di Sarno, L.; Rigante, D.; Candelli, M. Auxological and Metabolic Parameters of Children Undergoing the Gonadotropin-Releasing Hormone Stimulation Test: Correlations with the Final Diagnosis of Central Precocious Puberty in a Single-Center Study. Biomedicines 2023, 11, 1678. https://doi.org/10.3390/biomedicines11061678
Cipolla C, Sodero G, Pane LC, Mariani F, Di Sarno L, Rigante D, Candelli M. Auxological and Metabolic Parameters of Children Undergoing the Gonadotropin-Releasing Hormone Stimulation Test: Correlations with the Final Diagnosis of Central Precocious Puberty in a Single-Center Study. Biomedicines. 2023; 11(6):1678. https://doi.org/10.3390/biomedicines11061678
Chicago/Turabian StyleCipolla, Clelia, Giorgio Sodero, Lucia Celeste Pane, Francesco Mariani, Lorenzo Di Sarno, Donato Rigante, and Marcello Candelli. 2023. "Auxological and Metabolic Parameters of Children Undergoing the Gonadotropin-Releasing Hormone Stimulation Test: Correlations with the Final Diagnosis of Central Precocious Puberty in a Single-Center Study" Biomedicines 11, no. 6: 1678. https://doi.org/10.3390/biomedicines11061678