摘要
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.
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.
