ESPE2021 ePoster Category 2 Pituitary, neuroendocrinology and puberty (48 abstracts)
First Morning Voided Urinary Gonadotropin Measurements for the Early Screening, Diagnosis and Follow-up of Central Precocious Puberty Patients
Feng Ye 1 , Xiaoping Luo 1 , Guoqing Dong 2 , Ruimin Chen 3 , Zhiya Dong 4 , Wenli Lu 4 , Junfen Fu 5 , Shumin Zhan 5 , Feihong Luo 6 , Chunxiu Gong 7 , Liya Wei 7 , Yu Yang 8 , Min Zhu 9 , Huamei Ma 10 , Qiuli Chen 10 , Xinran Cheng 11 & Peng Gou 11
1Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China; 2Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China; 3Fuzhou Children’s Hospital of Fujian Province, Fuzhou, China; 4Ruijin Hospital, Shanghai Jiao Tong University Medical School, Shanghai, China; 5The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China; 6Children’s Hospital of Fudan University, Shanghai, China; 7Beijing Children’s Hospital, Capital Medical University, Beijing, China; 8Jiangxi Province Children’s Hospital, Nanchang, China; 9Children’s Hospital of Chongqing Medical University, Chongqing, China; 10First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; 11The Affiliated Women’s and Children’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
Central precocious puberty (CPP) is one of the most common pediatric endocrine diseases with an ever increasing incidence. CPP is associated with the loss of final adult height, early menarche, psychological problems and an increased risk of developing diseases in later adulthood such as female reproductive system tumors. The gonadotropin-releasing hormone stimulation test (GnRHST) is the gold standard for the diagnosis of CPP. However, the test is costly and time consuming to implement because the invasive method requires hospitalization and repeated evaluation with multiple serum sample collections, thus making the test not suitable for routine screening. A simple and effective method for identifying CPP remains to be developed. Recent studies have demonstrated that the first morning voided (FMV) urinary Gn(U-Gn) has a strong correlation with serum Gn(S-Gn) and performed equally well in predicting a pubertal GnRH test result. It also performed equally well as the GnRHST in the differentiation of early puberty (Tanner stage 2) from prepuberty (Tanner stage 1) and decreased after 3 months of GnRHa treatment to levels below +2 SDs. Thus, the non-invasive FMV U-Gn measurement can reflect the gonadotropin secretion for a particular period during the day and suggest higher accordance with GnRHST compared with S-Gn, which suggests that FMV U-Gn may be an ideal indicator for CPP screening, diagnosis and follow-up. However, a uniform standard has not been agreed due to the lack of large cohort, multi-center clinical research data. Therefore, it is of great clinical value and scientific significance to study further FMV U-Gn concentration changes and cut-off values. In the present study, 6,000 healthy children (aged 6-12 years) will be enrolled and classified at different Tanner stages in 11 centers in China to explore whether FMV U-Gn can be set at different cut-off values for predicting clinically established puberty (Tanner stage B/G 2) for boys and girls, and the ideal cut-off value will be determined. 400 precocious puberty (PP) patients will also be enrolled to determine if FMV U-Gn correlates with GnRHST results, and the sensitivity and specificity of U-Gn for diagnosis of CPP at different cut-off values will be evaluated to determine the ideal cut-off value. The CPP group will be followed up once every three months for a year to evaluate the value of FMV U-Gn in follow-ups of CPP patients.
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