Advanced bone age as an indicator facilitates the diagnosis of precocious puberty

Abstract

Objective: Diagnosis of central precocious puberty has always been challenging in clinicalpractice. As an important method in the diagnosis of central precocious puberty, luteinizinghormone‐releasing hormone stimulation test is complex and time‐consuming. In many cases, clinical traits are inconsistent with luteinizing hormone‐releasing hormone stimulation testresults, therefore not reliable for diagnosis. In this study, the authors intended to find an indi‐cator that predicts the results of the luteinizing hormone‐releasing hormone stimulation testamong subjects with early pubertal signs. Methods: Cases of 382 girls with early breast development before 8 years old and luteinizinghormone-releasing hormone stimulation test before 9 years old were included and underwentfollow-up tests. Patients with peak luteinizing hormone level ≥5 IU/L were considered positivein the luteinizing hormone-releasing hormone stimulation test. Anthropometric data, body massindex, bone age evaluation, blood hormones levels of luteinizing hormone, estradiol, follicle-stimulating hormone, and uterine and ovarian volumes were analyzed. Results: Subjects with positive results in the initial test demonstrated early bone maturation, accelerated growth, and elevated basal blood luteinizing hormone, estradiol, and follicle-stimulating hormone levels, when compared with subjects with negative results in the initialtest. Subjects with positive results in the follow-up test presented a more advanced bone ageand more accelerated linear growth, when compared with subjects with negative results in thefollow-up test. Conclusions: According to the statistical analysis, advanced bone age is the most effectivepredictor of the result of luteinizing hormone-releasing hormone stimulation test.

Keywords

• Central precocious puberty
• Bone age
• Luteinizing hormone‐releasing hormone stimulation test
• Growth velocity