Efficacy of morning serum LH combined with IGF-1 on pubertal initiation in children

LIU Hua; ZHANG Mengying; SONG Qing

doi:10.16835/j.cnki.1000-9817.2022.09.025

Volume 43 Issue 9

Sep. 2022

Turn off MathJax

Article Contents

Article Navigation > CHINESE JOURNAL OF SCHOOL HEALTH > 2022 > 43(9): 1383-1387

LIU Hua, ZHANG Mengying, SONG Qing. Efficacy of morning serum LH combined with IGF-1 on pubertal initiation in children[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2022, 43(9): 1383-1387. doi: 10.16835/j.cnki.1000-9817.2022.09.025

Citation:

LIU Hua, ZHANG Mengying, SONG Qing. Efficacy of morning serum LH combined with IGF-1 on pubertal initiation in children[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2022, 43(9): 1383-1387. doi: 10.16835/j.cnki.1000-9817.2022.09.025

Citation:

PDF( 408 KB)

Efficacy of morning serum LH combined with IGF-1 on pubertal initiation in children

doi: 10.16835/j.cnki.1000-9817.2022.09.025

1.
Department of Child Health Care, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan (430016), China

Received Date: 2022-05-05
Rev Recd Date: 2022-06-20

Available Online: 2022-09-23

Publish Date: 2022-09-25

Abstract

Abstract

Objective To explore the screening cut-off point and screening efficacy of morning serum LH combined with IGF-1 levels on puberty initiation to provide the basis for developing the gnrh stimulation test reasonably and promoting the systematic management of children and adolescence. Methods A retrospective study was conducted to select 1 724 children aged 8-13 years who took physical examination and were identified of breast development (between grade 2 and grade 3) or increased testicular volume (4.00-10.00 mL) in Child Health Department of Wuhan Children's Hospital during January 1st 2019 and December 31th 2021, and gonadotropin releasing hormone (GnRH) stimulation test was performed in endocrinology department ward in the same period.Doppler ultrasound was used to determine gonadal volume, and GnRH stimulation test was conducted to determine the puberty initiation in children.The ROC curve was utilized to determine the screening cut-off points of morning serum LH and IGF-1 on puberty initiation, and the reliability and validity of the cut-off points were all tested. Results The testicular volume was (4.88±2.19) mL in boys, and 75.5% was classified as initiation of gonadal growth.Whereas the ovaries volume was (1.78±0.65) mL in girls, and 91.39% classified as initiation of gonadal growth.The results of the GnRH stimulation test showed that among boys and girls, the medians LH peak were 13.22 and 21.79 IU/L, and the median LH/FSH peak ratios were 2.13 and 1.87.As a result, 597 boys and 864 girls were diagnosed as puberty initiation.Screening efficacy analysis indicated that the cut-off point of morning serum LH on puberty initiation were 0.23 IU/L in male (Kappa=0.60) and 0.22 IU/L in female (Kappa=0.66), and IGF-1 cut-off point were 187.00 IU/L in male (Kappa=0.45) and 178.00 IU/L in female (Kappa=0.46).High sensitivity and specificity and better screening efficacy (Kappa=0.60, 0.64) on single-item screening of morning blood LH in boys and tandem screening of LH and IGF-1 in girls. Conclusion Morning serum LH and IGF-1 are good predictors on puberty initiation.GnRH stimulation test should be carried out to determine the puberty initiation when morning serum LH reaches 0.23 IU/L in boys, morning serum LH reaches 0.22 IU/L and IGF-1 reaches 178.00 IU/L in girls.
- Blood,
- Luteinizing kormone,
- Insulin-like growth factor 1,
- Puberty,
- Growth and development,
- Child

FullText(HTML)

References(19)

References

[1]	HEO S, LEE Y S, YU J. Basal serum luteinizing hormone value as the screening biomarker in female central precocious puberty[J]. Am Pediatr Endocrinol Metab, 2019, 24(3): 164-171. doi: 10.6065/apem.2019.24.3.164
[2]	孙曼青, 陆文丽, 王伟, 等. 女童快速进展型中枢性性早熟早期预警及随访标志物的多中心研究[J]. 中华内分泌代谢杂志, 2017, 33(4): 312-316. doi: 10.3760/cma.j.issn.1000-6699.2017.04.008 SUN M Q, LU W L, WANG W, et al. A multi-center clinical study of early predictors and follow-up parameters for girls with rapidly progressive central precocious puberty[J]. Chin J Endocrinol Metab, 2017, 33(4): 312-316. doi: 10.3760/cma.j.issn.1000-6699.2017.04.008
[3]	KIM Y J, KWON A, JUNG M K, et al. Incidence and prevalence of central precocious puberty in korea: an epidemiologic study based on a national database[J]. J Pediatr, 2019, 208(3): 221-228.
[4]	梁雁, 杜敏联, 罗小平. 中枢性性早熟诊断与治疗共识(2015)[J]. 中华儿科杂志, 2015, 53(6): 412-418. doi: 10.3760/cma.j.issn.0578-1310.2015.06.004 LIANG Y, DU M L, LUO X P. Consensus on diagnosis and treatment of central precocious puberty (2015)[J]. Chin J Pediatr, 2015, 53(6): 412-418. doi: 10.3760/cma.j.issn.0578-1310.2015.06.004
[5]	陈荣华, 赵正言. 儿童保健学[M]. 5版. 南京: 江苏凤凰科学技术出版社, 2017: 106. CHEN R H, ZHAO Z Y. Child health science[M]. 5 ed. Nanjing: Jiangsu Phoenix Science and Technology Press, 2017: 106.
[6]	VNSAL V V, EBRU E A. Wnt pathway: a mechanism worth considering in endocrine disrupting chemical action[J]. Toxicol Ind Health, 2020, 36(1): 41-53. doi: 10.1177/0748233719898989
[7]	罗交, 陈燕容, 段若男, 等. 女孩青春期启动及发育趋势分析[J]. 卫生研究, 2015, 44(6): 1013-1018, 1046. https://www.cnki.com.cn/Article/CJFDTOTAL-WSYJ201506034.htm LUO J, CHEN Y R, DUAN R N, et al. Analysis of puberty initiation and developmental trends in girls[J]. J Hyg Res, 2015, 44(6): 1013-1018, 1046. https://www.cnki.com.cn/Article/CJFDTOTAL-WSYJ201506034.htm
[8]	罗交, 唐宇帆, 段若男, 等. 男生青春期启动及发育趋势[J]. 中国学校卫生, 2015, 36(11): 1756-1760. http://www.cjsh.org.cn/article/id/zgxxws201511054 LUO J, TANG Y F, DUAN R N, et al. The initiation and developmental trend of puberty in boys[J]. Chin J Sch Health, 2015, 36(11): 1756-1760. http://www.cjsh.org.cn/article/id/zgxxws201511054
[9]	王卫平, 孙锟, 常立文. 儿科学[M]. 9版. 北京: 人民卫生出版社, 2020: 401-402. WANG W P, SUN K, CHANG L W. Pediatrics[M]. 9 ed. Beijing: People's Health Publishing House, 2020: 401-402.
[10]	唐海飞, 王智文, 郑雪松, 等. 雌激素功能研究进展[J]. 中华生殖与避孕杂志, 2019, 39(4): 334-340. https://www.cnki.com.cn/Article/CJFDTOTAL-SPKX202107001.htm TANG H F, WANG Z W, ZHENG X S, et al. Research progress of estrogen function[J]. Reprod Contracep, 2019, 39(4): 334-340. https://www.cnki.com.cn/Article/CJFDTOTAL-SPKX202107001.htm
[11]	王晋, 罗红, 庞厚清, 等. 儿童至青春期子宫卵巢超声测值及超声对性早熟的诊断价值[J]. 四川大学学报(医学版), 2019, 50(4): 583-587. https://www.cnki.com.cn/Article/CJFDTOTAL-HXYK201904027.htm WANG J, LUO H, PANG H Q, et al. Ultrasound measurement of uterus and ovary in children to puberty and the diagnostic value of ultrasound in precocious puberty[J]. J Sichuan Univ (Med Ed), 2019, 50(4): 583-587. https://www.cnki.com.cn/Article/CJFDTOTAL-HXYK201904027.htm
[12]	XU Y J, XIONG J Y, GAO W K, et al. Dietary fat and polyunsaturated fatty acid intakes during childhood are prospectively associated with puberty timing independent of dietary protein[J]. Nutrients, 2022, 14(2): 275-286. doi: 10.3390/nu14020275
[13]	杨蓉, 马梅, 王子健. 雌激素干扰物的联合毒性研究进展[J]. 生态毒理学报, 2020, 15(5): 18-27. https://www.cnki.com.cn/Article/CJFDTOTAL-STDL202005002.htm YANG R, MA M, WANG Z J. Recent research advances in joint toxicity of estrogenic disruptors[J]. Asian J Ecotoxicol, 2020, 15(5): 18-27. https://www.cnki.com.cn/Article/CJFDTOTAL-STDL202005002.htm
[14]	ROSENFIELD R L. Normal and premature adrenarche[J]. Endocr Rev, 2021, 42(6): 783-814. doi: 10.1210/endrev/bnab009
[15]	SEMAAN S J, KAUFFMAN A S. Developmental sex differences in the peri-pubertal pattern of hypothalamic reproductive gene expression, including Kiss1 and Tac2, may contribute to sex differences in puberty onset[J]. Mol Cell Endocrinol, 2022, 551: 111654. doi: 10.1016/j.mce.2022.111654
[16]	NATALIE G A, KANTHI B K, PETER A. Use of gonadotropin-releasing hormone analogs in children[J]. Curr Opin Pediatr, 2021, 33(4): 442-448. doi: 10.1097/MOP.0000000000001026
[17]	朱俊. 儿童IGF-1浓度与骨龄及年龄的相关性研究[J]. 交通医学, 2019, 33(6): 636-637. https://www.cnki.com.cn/Article/CJFDTOTAL-JTYX201906034.htm ZHU J. Study on the correlation between IGF-1 concentration and bone age and age in children[J]. Traffic Med, 2019, 33(6): 636-637. https://www.cnki.com.cn/Article/CJFDTOTAL-JTYX201906034.htm
[18]	KHAN L. Puberty: onset and progression[J]. Pediatr Ann, 2019, 48(4): e141-e145.
[19]	ENZA G, ROSA L, STEFANO C, et al. Linear growth and puberty in childhood obesity: what is new?[J]. Minerv Pediatr, 2021, 73(6): 563-571.