<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>The criterion standard gonadotropin-releasing hormone (GnRH) stimulation tests to diagnose central precocious puberty (CPP) are time-consuming, inconvenient, and expensive.</p>
</sec>
<sec><h3>Objectives</h3>
<p>To determine predictive cut-off values codetermined by ultrasonographic parameters and basal gonadotropin levels in girls with premature sexual development and compare them results of criterion standard tests in a study of diagnostic accuracy.</p>
</sec>
<sec><h3>Methods</h3>
<p>Retrospective review of hormonal investigations and ultrasonographic uterine and ovarian parameters in a consecutive sample of girls at a single center, tertiary care hospital in Bangkok, Thailand.</p>
</sec>
<sec><h3>Results</h3>
<p>We separated data from 68 girls (age range 2–12 years) into 2 groups based on their response to a GnRH analogue agonist stimulation test. A “prepubertal response” group included girls with premature thelarche and thelarche variants (n = 18, 6.37 ± 1.77 years) and a “pubertal response” group, including girls with CPP (n = 50, 8.46 ± 1.46 years); excluding patients with pathological causes (n = 0). The basal level of luteinizing hormone (LH) had the largest area under receiver operating characteristic curves (AUC) of 0.84; 95% confidence interval [CI] 0.74–0.93) compared with basal levels of follicle stimulating hormone (AUC 0.77; 95% CI 0.64–0.90) or estradiol (0.70; 95% CI 0.56–0.85). An optimal cut-off of 0.25 IU/L LH was related to a pubertal response to GnRH analogue agonist stimulation tests with 75.0% sensitivity, 88.9% specificity, 94.7% positive predictive value (PPV), and 57.1% negative predictive value. Uterine and ovarian cut-off volumes of 3.5 cm<sup>3</sup> and 1.5 cm<sup>3</sup> were related to a pubertal response with 88.6% and 76.2% PPV, respectively. A uterine width cut-off of 1.7 cm combined with a basal LH cut-off of 0.25 IU/L increased specificity and PPV to 100%.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>Combining uterine and ovarian ultrasonographic parameters with basal gonadotropin levels, especially uterine width and basal LH level, appears useful for diagnosis of CPP.</p>
</sec>
</abstract>

Background
The criterion standard gonadotropin-releasing hormone (GnRH) stimulation tests to diagnose central precocious puberty (CPP) are time-consuming, inconvenient, and expensive.

Objectives
To determine predictive cut-off values codetermined by ultrasonographic parameters and basal gonadotropin levels in girls with premature sexual development and compare them results of criterion standard tests in a study of diagnostic accuracy.

Methods
Retrospective review of hormonal investigations and ultrasonographic uterine and ovarian parameters in a consecutive sample of girls at a single center, tertiary care hospital in Bangkok, Thailand.

Results
We separated data from 68 girls (age range 2–12 years) into 2 groups based on their response to a GnRH analogue agonist stimulation test. A “prepubertal response” group included girls with premature thelarche and thelarche variants (n = 18, 6.37 ± 1.77 years) and a “pubertal response” group, including girls with CPP (n = 50, 8.46 ± 1.46 years); excluding patients with pathological causes (n = 0). The basal level of luteinizing hormone (LH) had the largest area under receiver operating characteristic curves (AUC) of 0.84; 95% confidence interval [CI] 0.74–0.93) compared with basal levels of follicle stimulating hormone (AUC 0.77; 95% CI 0.64–0.90) or estradiol (0.70; 95% CI 0.56–0.85). An optimal cut-off of 0.25 IU/L LH was related to a pubertal response to GnRH analogue agonist stimulation tests with 75.0% sensitivity, 88.9% specificity, 94.7% positive predictive value (PPV), and 57.1% negative predictive value. Uterine and ovarian cut-off volumes of 3.5 cm3 and 1.5 cm3 were related to a pubertal response with 88.6% and 76.2% PPV, respectively. A uterine width cut-off of 1.7 cm combined with a basal LH cut-off of 0.25 IU/L increased specificity and PPV to 100%.

Conclusion
Combining uterine and ovarian ultrasonographic parameters with basal gonadotropin levels, especially uterine width and basal LH level, appears useful for diagnosis of CPP.

Sensitivity and specificity of using pelvic ultrasonographic parameters combined with basal gonadotropin levels to diagnose central precocious puberty in Thai girls

Department of Pediatrics, Faculty of Medicine

Department of Radiology, Faculty of Medicine

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Background
The criterion standard gonadotropin-releasing hormone (GnRH) stimulation tests to diagnose central precocious puberty (CPP) are time-consuming,...

Sensitivity and specificity of using pelvic ultrasonographic parameters combined with basal gonadotropin levels to diagnose central precocious puberty in Thai girls

Article Category: Brief communication (original)

Published Online: Feb 21, 2021

Page range: 27 - 34

DOI: https://doi.org/10.2478/abm-2021-0004

Keywords
diagnostic imaging, gonadotropins, pelvis, puberty, precocious, ultrasonography

© 2021 Hataichanok B. Kongmanas et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Sensitivity and specificity of using pelvic ultrasonographic parameters combined with basal gonadotropin levels to diagnose central precocious puberty in Thai girls

Article Category: Brief communication (original)

Published Online: Feb 21, 2021

Page range: 27 - 34

DOI: https://doi.org/10.2478/abm-2021-0004

Keywordsdiagnostic imaging, gonadotropins, pelvis, puberty, precocious, ultrasonography

© 2021 Hataichanok B. Kongmanas et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
diagnostic imaging, gonadotropins, pelvis, puberty, precocious, ultrasonography