PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to distinguish isolated hypogonadotropic hypogonadism (IHH) from constitutional delay in growth and puberty (CDGP) by various hormonal tests in both sexes.
UNASSIGNED: Boys with testicular volume (TV) <4 ml (14-18 years) and girls with breast B1 stage (13-18 years) were enrolled in this study. A detailed history, clinical examination and hormonal analysis including basal luteinising hormone (LH), follicle-stimulating hormone (FSH), inhibin B, anti-Mullerian hormone (AMH), testosterone (boys), oestradiol (girls), triptorelin stimulation test and 3-day human chorionic gonadotropin (HCG) stimulation test (boys) were performed. All patients were followed for 1.5 years or till 18 years of age. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-offs with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for various hormones to distinguish IHH from CDGP.
UNASSIGNED: Of 34 children (male: 22 and female: 12), CDGP and IHH were diagnosed in 21 and 13 children, respectively. 4 hours post-triptorelin LH had the highest sensitivity (100%) and specificity (100%) for identifying IHH in both sexes. Basal inhibin B had good sensitivity (male: 85.7% and female: 83.8%) and specificity (male: 93.3% and female: 100%) for diagnosing IHH. 24 hours post-triptorelin testosterone (<34.5 ng/dl), day 4 post-HCG testosterone (<99.7 ng/dl) and 24 hours post-triptorelin oestradiol (<31.63 pg/ml) had reasonable sensitivity and specificity for identifying IHH. Basal LH, FSH and AMH were poor discriminators for IHH in both sexes.
UNASSIGNED: The best indicator was post-triptorelin 4-hour LH followed by inhibin B, which had a reasonable diagnostic utility to distinguish IHH from CDGP in both boys and girls.
UNASSIGNED: Boys with testicular volume (TV) <4 ml (14-18 years) and girls with breast B1 stage (13-18 years) were enrolled in this study. A detailed history, clinical examination and hormonal analysis including basal luteinising hormone (LH), follicle-stimulating hormone (FSH), inhibin B, anti-Mullerian hormone (AMH), testosterone (boys), oestradiol (girls), triptorelin stimulation test and 3-day human chorionic gonadotropin (HCG) stimulation test (boys) were performed. All patients were followed for 1.5 years or till 18 years of age. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-offs with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for various hormones to distinguish IHH from CDGP.
UNASSIGNED: Of 34 children (male: 22 and female: 12), CDGP and IHH were diagnosed in 21 and 13 children, respectively. 4 hours post-triptorelin LH had the highest sensitivity (100%) and specificity (100%) for identifying IHH in both sexes. Basal inhibin B had good sensitivity (male: 85.7% and female: 83.8%) and specificity (male: 93.3% and female: 100%) for diagnosing IHH. 24 hours post-triptorelin testosterone (<34.5 ng/dl), day 4 post-HCG testosterone (<99.7 ng/dl) and 24 hours post-triptorelin oestradiol (<31.63 pg/ml) had reasonable sensitivity and specificity for identifying IHH. Basal LH, FSH and AMH were poor discriminators for IHH in both sexes.
UNASSIGNED: The best indicator was post-triptorelin 4-hour LH followed by inhibin B, which had a reasonable diagnostic utility to distinguish IHH from CDGP in both boys and girls.
摘要：
■这项研究旨在通过男女的各种激素测试将孤立的低促性腺激素性腺功能减退症（IHH）与生长和青春期（CDGP）的宪法延迟区分开。
■睾丸体积（TV）<4ml（14-18岁）的男孩和乳腺B1期（13-18岁）的女孩被纳入本研究。详细的历史，临床检查和激素分析，包括基础黄体生成素（LH），卵泡刺激素（FSH），抑制素B,抗苗勒管激素（AMH），睾丸激素（男孩），雌二醇（女孩），进行曲普瑞林刺激试验和3天的人绒毛膜促性腺激素（HCG）刺激试验（男孩）。所有患者均随访1.5年或至18岁。进行接收器工作特性（ROC）曲线分析以确定具有灵敏度的最佳截止值，特异性，各种激素的阳性预测值（PPV）和阴性预测值（NPV），以区分IHH和CDGP。
■34个孩子（男：22，女：12），在21和13名儿童中诊断出CDGP和IHH，分别。曲普瑞林LH后4小时对鉴定两种性别的IHH具有最高的灵敏度(100%)和特异性(100%)。基础抑制素B对诊断IHH具有良好的敏感性（男性：85.7％，女性：83.8％）和特异性（男性：93.3％，女性：100％）。曲普瑞林睾酮后24小时（<34.5ng/dl），HCG后第4天睾酮(<99.7ng/dl)和曲普瑞林雌二醇后24小时(<31.63pg/ml)对鉴定IHH具有合理的敏感性和特异性。基础LH,FSH和AMH在两种性别中都是IHH的差别性。
■最好的指标是服用曲普瑞林后4小时LH，然后是抑制素B，这对区分男孩和女孩的IHH和CDGP具有合理的诊断效用。
■睾丸体积（TV）<4ml（14-18岁）的男孩和乳腺B1期（13-18岁）的女孩被纳入本研究。详细的历史，临床检查和激素分析，包括基础黄体生成素（LH），卵泡刺激素（FSH），抑制素B,抗苗勒管激素（AMH），睾丸激素（男孩），雌二醇（女孩），进行曲普瑞林刺激试验和3天的人绒毛膜促性腺激素（HCG）刺激试验（男孩）。所有患者均随访1.5年或至18岁。进行接收器工作特性（ROC）曲线分析以确定具有灵敏度的最佳截止值，特异性，各种激素的阳性预测值（PPV）和阴性预测值（NPV），以区分IHH和CDGP。
■34个孩子（男：22，女：12），在21和13名儿童中诊断出CDGP和IHH，分别。曲普瑞林LH后4小时对鉴定两种性别的IHH具有最高的灵敏度(100%)和特异性(100%)。基础抑制素B对诊断IHH具有良好的敏感性（男性：85.7％，女性：83.8％）和特异性（男性：93.3％，女性：100％）。曲普瑞林睾酮后24小时（<34.5ng/dl），HCG后第4天睾酮(<99.7ng/dl)和曲普瑞林雌二醇后24小时(<31.63pg/ml)对鉴定IHH具有合理的敏感性和特异性。基础LH,FSH和AMH在两种性别中都是IHH的差别性。
■最好的指标是服用曲普瑞林后4小时LH，然后是抑制素B，这对区分男孩和女孩的IHH和CDGP具有合理的诊断效用。
