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KMID : 1143620160200020054
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Korean Journal of Nuclear Medicine Technology
2016 Volume.20 No. 2 p.54 ~ p.61
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Clinical Characteristics of precocious puberty girls and Comparison Analysis of GnRH Test results with Diagnosis type
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Kim Jung-In
Kwon Won-Hyun
Moon Ki-Choon
Lee In-Won
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Abstract
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Purpose : Precocious Puberty is defined as the development of secondary sexual characteristics in girls younger than 8
years, and boys 9 years. Cause premature closure of the epiphysis is a disease that eventually decreases the final adult height. In this study, we retrospectively analyzed to evaluate the diagnostic difference the GnRH (Gonado-tropin-releasing Hormone) stimulation test results with medical records of precocious puberty in girls.
Materials and Methods : From February 2015 to December 2015 it was enrolled in the girls 118 people who visited the Seoul National University Bundang Hospital, Pediatrics, Endocrinology Internal Medicine. True precocious puberty group (n=57), early puberty group (n=39), were divided into Premature thelarche (n=22) group. A Tanner stage, chronological age, bone age, height, body weight for each group was determined by examining the mean±standard deviation. GnRH test result was compared LH (Basal, 30 min, 45 min, 60 min), FSH (Basal, 30 min, 60 min) for each group, Each group LH, FSH Peak
value distribution, the mean±standard deviation was calculated for the peak LH/LH basal ratio, peak LH/Peak FSH
ratio. The significance probability (P-value) between the value of each third group was determined.
Results : The average height of the true precocious puberty group 131± 14.85, the mean weight was 28.80±4.93, the average chronological age 7.1± 0.81, the mean bone age was 9.9±0.9, The average height of early puberty group was 134±5.10, the average weight 28.50±4.43, the average chronological age 8.05±0.03, the mean bone age was 10.0±0.62, The average height of Premature thelarche 129±6,01, the average weight was 28.65 ± 5.98, the average chronological age 7.02 ± 0.58, the mean bone age was 8.04 ± 1.29. There was no significant difference when compared to the height and weight. There was a significant difference between the groups in the chronologic age and bone age difference (P <0.0002) True precocious puberty group showed peak LH levels at 30’(82.5%), 45’(12.3%), 60’(5.3%), in Peak FSH 30’(8.8%), 60’(91.2%). Early Puberty group showed high values in Peak LH at 30’(79.5%), 45’(17.9%), 60’(2.6%), in peak FSH levels at 30’(7.7%), 60’(92.32%). In Premature thelarche Group it showed the Peak LH levels at 30’(30%), 45’(59%), 60'(9.09%), Peak FSH levels at 30’(0%) 60’(100%). When compared with the The Peak LH/basal LH ratio, True precocious puberty group was 19.09 ± 17.15, early puberty group was 15.23±10.88, Premature thelarche group showed significant differences between the three groups as 4.93±4.36.(P <0.0001) LH Peak/FSH Peak ratio, true precocious puberty group was 1.222±0.77, early puberty group was 1.34±1.23, Premature thelarche group showed significant differences between the three groups as 0.3±0.09(P <0.0001)
Conclusion : In order to diagnose the true precocious puberty have a diagnostic value when the LH peak after GnRH stimulation is increased by more than two to three times compared to baseline or a predetermined level or more than 5~10 IU/L increases. GnRH Test is a test for a long time and the patient discomfort due to repeated blood sampling, but the hypothalamus-pituitary gland- gonad axis activity evaluate and is the most basic accurate test in the differential diagnosis of precocious puberty disorders.
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KEYWORD
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chronologic age, bone age, true precocious puberty, early puberty, Premature thelarche
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