ESPE Abstracts

Objective: To explore the diagnostic value of morning urinary gonadotropins for assessing central precocious puberty (CPP) in girls with varying BMI and the potential use of first morning voided urinary luteinizing hormone (FMV ULH) in monitoring CPP treatment.

Methods: A total of 335 precocious puberty girls were selected. Data of serum luteinizing hormone (LH), follicle stimulating hormone (FSH), gonadotropin-releasing hormone (GnRH) stimulation test results, bone age and pelvic color ultrasound were collected. Participants were categorized into a normal weight group and an overweight/obese group. Detection of FMV ULH and morning urinary follicle-stimulating hormone (FMV UFSH) at first visit. 64 girls with CPP who were treated with gonadotropin-releasing hormone analogues (GnRHa) were followed up every three months. Data were analyzed using the t-test, Mann-Whitney U test, Spearman correlation analysis, Wilcoxon signed-rank sum test, and Logistic regression.

Results: There were 225 girls in the normal-weight group and 110 in the overweight/obese group. Levels of FMV ULH, FMV ULH and FMV ULH/UFSH were significantly positively correlated with the corresponding serum hormone. The areas under ROC curve (AUC) of FMV ULH for CPP diagnosis in normal weight and overweight/obese groups were 0.801 and 0.822, the maximum of the Yoden indexes were 0.520 and 0.567, the optimal cut-off points were 1.055IU/L and 0.715IU/L, the sensitivity were 60.0% and 79.8%, and the specificity were 92.0% and 76.9%, respectively. When normal-weight girls with precocious puberty meet the condition of 2.632×ULH-0.160×UFSH>1.759, the specificity of CPP diagnosis was 96.0%, and the sensitivity was 54.9%. When overweight/obese girls with precocious puberty meet the condition of 3.023×ULH-0.209×UFSH>1.915, the specificity of CPP diagnosis was 96.2%, and the sensitivity was 47.6%. Among 64 CPP girls who received GnRHa treatment and were followed up 3 months or more, the FMV ULH and FMV UFSH were significantly decreased after 3 months of treatment. The median of FMV ULH value was decreased from 2.12IU/L to 0.48IU/L after 3 months of treatment and 0.17IU/L after 1 year of treatment.

Conclusion: FMV ULH demonstrates satisfied diagnostic value for CPP in girls, and the optimal threshold point for FMV ULH diagnosis of CPP in overweight/obese girls is lower than that in normal-weight girls. The application of FMV ULH and UFSH combined indicators can improve the specificity of the diagnosis of CPP in girls with different BMI. The FMV ULH can be used as a proficient indicator for assessing the efficacy of GnRHa therapy.