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

Hataichanok B. Kongmanas
Hataichanok B. Kongmanas
, 
Panruethai Trinavarat
Panruethai Trinavarat
 and 
Suttipong Wacharasindhu
Suttipong Wacharasindhu
   | Feb 21, 2021
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Article Category: Brief communication (original)
Published Online: Feb 21, 2021
Page range: 27 - 34
DOI: https://doi.org/10.2478/abm-2021-0004
Keywords
© 2021 Hataichanok B. Kongmanas et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Flow diagram showing the flow of participants though the study. CPP, central precocious puberty; GnRH, gonadotropin-releasing hormone; LH, luteinizing hormone.
Flow diagram showing the flow of participants though the study. CPP, central precocious puberty; GnRH, gonadotropin-releasing hormone; LH, luteinizing hormone.

Figure 2

Receiver operating characteristic curves for various ultrasonographic and hormonal parameters. A. Basal luteinizing hormone. B. Basal follicle stimulating hormone. C. Basal estradiol. D. Uterine volume. E. Uterine width. F. Uterine length. G. Uterine thickness. H. Bilateral ovarian volume. Solid lines indicate the variable parameter and dashed lines indicate a reference line. Diagonal segments are produced by ties.
Receiver operating characteristic curves for various ultrasonographic and hormonal parameters. A. Basal luteinizing hormone. B. Basal follicle stimulating hormone. C. Basal estradiol. D. Uterine volume. E. Uterine width. F. Uterine length. G. Uterine thickness. H. Bilateral ovarian volume. Solid lines indicate the variable parameter and dashed lines indicate a reference line. Diagonal segments are produced by ties.

Area under the ROC curve, cut off point, sensitivity, specificity, PPV, and NPV of each ultrasonographic and hormonal parameters

Parameter AUC 95% CI Cut-off Sensitivity (%) Specificity (%) PPV (%) NPV (%)
Basal LH (IU/L) 0.84 0.74–0.93 0.25 75.0 88.9 94.7 57.1
Basal FSH (IU/L) 0.77 0.64–0.90 1 85.4 55.6 83.7 58.8
Basal estradiol (pg/mL) 0.70 0.56–0.85 25 76.2 61.1 82.1 52.4
Uterine width (cm) 0.80 0.66–0.94 1.7 83.7 58.3 87.8 50.0
Uterine thickness (cm) 0.78 0.66–0.90 1 73.5 64.7 85.7 45.8
Uterine length (cm) 0.72 0.60–0.85 3.5 62.0 64.7 83.8 36.7
Uterine volume (cm3) 0.83 0.72–0.95 3.5 73.8 66.7 88.6 42.1
Bilateral ovarian volume (cm3) 0.66 0.524–0.805 1.5 71.1 41.2 76.2 35.0

Sensitivity, specificity, PPV, and NPV when combining uterine ultrasonographic and basal hormonal parameters

Uterine ultrasonographic parameter Cut-off Basal hormonal parameter Cut-off Sensitivity (%) Specificity (%) PPV (%) NPV (%)
Width (cm) 1.7 Basal LH 0.25 65.9 100 100 46.2
Width (cm) 1.7 Basal FSH 1.5 63.4 91.7 96.3 42.3
Volume (cm3) 3.0 Basal LH 0.25 65.0 91.7 96.3 44.0
Length (cm) 3.5 Basal LH 0.25 50.0 94.1 96.0 40.0
Thickness (cm) 0.9 Basal FSH 1 68.1 70.6 86.5 44.4
Width (cm) 1.7 Basal FSH 1 68.3 83.3 93.3 43.5
Width (cm) 1.7 Basal E2 25 69.4 83.3 92.6 47.6

Clinical and laboratory characteristics of the girls with a prepubertal (PT, TV) or pubertal response (CPP) to a GnRH stimulation test

Parameter Prepubertal response (n = 18) Pubertal response (n = 50) P
Mean (SD) Mean (SD)
Chronological age (years) 6.37 (1.77) range 2–8.2 8.46 (1.46) range 4.8–11 0.41
Bone age (years) 7.91 (2.05) range 4–11 10.43 (1.88) range 6.8–12 0.85
Uterine length (cm) 3.34 (0.64) 4.25 (1.18) 0.007*
Uterine thickness (cm) 0.95 (0.39) 1.53 (0.71) 0.001*
Uterine width (cm) 1.49 (0.60) 2.43 (0.96) 0.31
Uterine volume (cm3) 2.56 (1.53) 10.96 (11.58) 0.001*
Bilateral ovarian length (cm) 1.31 (0.31) 1.48 (0.43) 0.20
Bilateral ovarian thickness (cm) 1.09 (0.30) 1.32 (0.44) 0.15
Bilateral ovarian width (cm) 1.30 (0.31) 1.43 (0.37) 0.53
Bilateral ovarian volume (cm3) 1.69 (0.71) 2.77 (2.06) 0.01*
Basal LH (IU/L) 0.22 (0.35) 2.63 (3.99) 0.001*
Basal FSH (IU/L) 1.34 (1.51) 2.90 (1.97) 0.03*
Basal E2 (pg/mL) 51.9 (54.6) 134.6 (182.2) 0.049*
Peak LH (IU/L) 4.33 (2.75) 41.29 (36.19) <0.001*
Peak FSH (IU/L) 9.45 (4.49) 13.19 (5.61) 0.28
Peak E2 (pg/mL) 53.9 (45.6) 139.7 (196.3) 0.10
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