ESPE Abstracts (2023) 97 P1-143

ESPE2023 Poster Category 1 Pituitary, Neuroendocrinology and Puberty (73 abstracts)

Comparison of the Test Accuracy of a Subcutaneous Gonadotropin-Releasing Hormone Agonist (Triptorelin Acetate) vs. Intravenous Gonadorelin in the Diagnosis of Central Precocious Puberty

Jungmin Ahn 1 & Hwal Rim Jeong 2

1Department of Pediatrics, Jeju National University School of Medicine, Jeju-si, Korea, Republic of. 2Department of Pediatrics, College of Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan-si, Korea, Republic of

Purpose: In the diagnosis of central precocious puberty (CPP), the gonadotropin-releasing hormone (GnRH) stimulation test using intravenously injected gonadorelin is the gold standard. However, gonadorelin is not always readily available. In this study, the diagnostic accuracy of a test based on the GnRH agonist triptorelin acetate (triptorelin) was compared to that of the classical gonadorelin-based test in the diagnosis of CPP in girls.

Methods: A retrospective chart review was performed to compare the clinical outcome of patients who underwent a GnRH stimulation test performed using intravenous gonadorelin (n= 74) vs. a subcutaneous triptorelin acetate test (triptorelin) test (n= 74). Among the 148 patients, 74 had CPP and 74 had precocious thelarche (PT). Luteinizing hormone (LH) and follicle-stimulating hormone levels were measured 0, 30, 60, 120, and 180 min after triptorelin injection, and 0, 30, 45, 60, and 90 min after gonadorelin injection. CPP was defined as a peak LH concentration ≥ 5.0 IU/L and PT as a peak LH concentration < 5.0 IU/L. The peak LH time detected by each method was compared, and the diagnostic value of the triptorelin test for CPP was determined in a receiver operating characteristic analysis.

Results: Peak LH after gonadorelin injection was measured at 30 min in 48% of patients, at 45 min in 47%, and at 60 min in 5.0%. After triptorelin injection, LH levels peaked at 30 min in 8%, at 60 min in 49%, at 120 min in 8.5%, and at 180 min in 35%. In the triptorelin test for the diagnosis of CPP, the peak LH cutoff value of 5.02 IU/L provided a sensitivity of 100% and a specificity of 100%.

Conclusion: The triptorelin test has a high diagnostic accuracy in the differential diagnosis of CPP vs. PT in girls, thus providing an effective alternative to the classic gonadorelin-based GnRH test. It should be noted that the peak LH concentration after triptorelin stimulation is likely to be reached later than after gonadorelin stimulation.

Volume 97

61st Annual ESPE (ESPE 2023)

The Hague, Netherlands
21 Sep 2023 - 23 Sep 2023

European Society for Paediatric Endocrinology 

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