| Autor: |
Binder, Gerhard, Schweizer, Roland, Blumenstock, Gunnar, Braun, Regina |
| Předmět: |
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| Zdroj: |
Clinical Endocrinology; Jan2015, Vol. 82 Issue 1, p100-105, 6p |
| Abstrakt: |
Objective The distinction between constitutional delay of growth and puberty ( CDGP) and isolated hypogonadotropic hypogonadism ( IHH) in males with delayed puberty is difficult but important for timely treatment. We assessed the accuracy of the Gn RH agonist test (triptorelin 0·1 mg) in comparison with inhibin B alone or in combination with basal LH for the diagnosis of IHH. Patients and measurements Ninety-seven prepubertal males aged 13·7-17·5 year, with testicular volumes ≤4 ml, were examined every 6 months. CDGP was defined by a testicular volume ≥8 ml after 18 months, and IHH was defined by a testicular volume <5 ml after 24 months follow-up. Inhibin B concentrations were measured by ELISA, and LH concentrations were measured by CLIA. Results At follow-up, the cohort comprised 52 boys with CDGP and nine with IHH. The other patients were lost for follow-up ( n = 10), had not reached follow-up yet ( n = 20) or did not reach a definite testicular volume ( n = 6). Basal LH <0·3 IU/l, stimulated LH (4 h) <5·3 IU/l or inhibin B <111 pg/ml had 100% sensitivity for IHH. Only LH (4 h) <5·3 IU/l had a specificity of 100%, and the specificities of basal LH <0·3 IU/l (88%) or inhibin B <110 pg/ml (92%) were lower. The combination of LH <0·3 IU/l with inhibin B <111 pg/ml increased the specificity to 98·1%. Conclusions The LH response 4 h after Gn RH agonist stimulation has an excellent accuracy for the diagnosis of IHH in prepubertal boys with delayed puberty. However, the measurement of inhibin B and basal LH in combination is a valid, reliable and less-invasive alternative test. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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