ESPE Abstracts

Objective of the research: To compare clinical laboratory and genitometric parameters in girls with hypogonadotropic hypogonadism (HH) and constitutional delayed puberty (CDP).

Materials and Methods: 23 female patients with delayed puberty are included in the study.

Inclusion criteria: Absence of secondary sexual characteristics at age ≥13 years or absence of menarche at age ≥15 years or absence of menarche for 3 years or more from the onset of estrogen-dependent signs of puberty.

Noninclusion criteria: Age ≥18 years, abnormal external genitalia, hypergonadotropic hypogonadism. All patients were evaluated the stage of puberty according to the Tanner scale, anthropometric parameters, bone age according to the Greulich-Pyle method, genitometric parameters, LH (1.9-14.2 mIU/mL), FSH (2.5-11.2 mIU/mL), E2 (30-393 pmol/L), inhibin B (20-177 pg/mL), AMH (˂8.9 ng/mL), prolactin (70-600 mIU/L), testosterone (0.29-1.67nmol/L), insulin-like growth factor (IGF-1; 188.4-509.9 ng/mL) in serum, GnRH analogue test results (triptorelin 0.1 mg).

Results: All patients were divided into 2 groups: girls with HH (group I) and girls with CPD (group II). HH was detected in 39.2% (9/23) of the girls. CDP was detected in 60.8% (14/23): 28.5% (4/14) of girls had no secondary sexual characteristics in their decree periods, and 71.5% (10/14) had primary amenorrhea. The reasons for treatment did not differ between the two groups: secondary sex characteristics were absent in 66.6% (6/9) of group I patients and 28.6% (4/14, P=0.102) of group II patients. Girls in both groups had similar height, body mass index, and bone age. According to the hormonal examination, girls with HH had significantly lower serum levels of E2, inhibin B, prolactin, and basal levels of gonadotropic hormones. The groups did not differ in serum AMH levels. According to GnRH analogue test results, the maximum LH level after 1 hour was significantly more frequent in group I, after 4 hours with equal frequency in both groups, after 24 hours - significantly more frequent in group II. Girls with HH had significantly lower uterus volume, ovaries volume, and linear M-Echo size. Conclusions: HH in girls is characterized by low serum levels of gonadotropic hormones, estradiol, inhibin B, IGF-1, and prolactin, a less pronounced LH and FSH response to stimulation with GnRH analogue, smaller uterus volume, ovaries volume, linear M-echo size, and delayed bone maturation compared with constitutional delayed puberty. No patient with CDP had a stimulated LH level less than 3.39 mIU/ml on the GnRH analogue test.