A single luteinizing hormone determination 2 hours after depot leuprolide is useful for therapy monitoring of gonadotropin-dependent precocious puberty in girls
A single luteinizing hormone determination 2 hours after depot leuprolide is useful for therapy monitoring of gonadotropin-dependent precocious puberty in girls
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DOI：
10.1210/jc.2003-031537
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发表时间：
2004-09-01
影响因子：
5.8
通讯作者：
Mendonca, BB
中科院分区：
文献类型：
--
作者：
Brito, VN;Latronico, AC;Mendonca, BB
长效GnRH类似物代表促性腺激素依赖性早熟的标准治疗。本研究的目的是确定激素参数，以监测醋酸亮丙瑞林贮库型制剂治疗在临床和激素诊断为促性腺激素依赖性早熟的女孩中的充分性。18名女孩每月接受3.75 mg醋酸亮丙瑞林长效制剂治疗。根据临床参数和青春期前LH水平，18名女孩中有16名在治疗期间实现了充分的下丘脑-垂体-性腺轴抑制。在这16例控制良好的女孩中，将经典GnRH试验后的LH峰值与GnRH类似物治疗前和治疗期间醋酸亮丙瑞林贮库型制剂给药后2小时获得的单次LH测量值进行比较。治疗前，经典GnRH试验后的平均+/- SDLH峰值为18.4 +/- 11.2 IU/L（范围为7 - 41.5 IU/L），首次贮库型亮丙瑞林给药后2小时为22.6 +/- 8.3 IU/L（范围为10 - 35.3 IU/L）。治疗期间，经典GnRH试验后LH峰值的平均+/- SD为1.4 +/- 0.6 IU/L（范围为< 0.6 - 2.3 IU/L），长效亮丙瑞林后2 h为2.7 +/- 1.9 IU/L（范围为0.7 - 6.6 IU/L）。治疗前和治疗期间，经典GnRH试验后的LH峰和长效亮丙瑞林给药后2 h的LH峰显著相关。总之，我们将适当的长效型亮丙瑞林治疗的LH临界值确定为经典GnRH检测后LH峰值低于2.3 IU/L或长效型亮丙瑞林治疗后2小时低于6.6 IU/L。后者测量可能取代经典的GnRH测试作为一个可靠和方便的工具，监测治疗女性促性腺激素依赖性性早熟。
Long-acting GnRH analogs represent the standard treatment for gonadotropin-dependent precocious puberty. The aim of this study was to determine the hormonal parameters for monitoring the adequacy of depot leuprolide acetate treatment in girls with clinical and hormonal diagnosis of gonadotropin-dependent precocious puberty. Eighteen girls were treated monthly with 3.75 mg depot leuprolide acetate. Adequate hypothalamic-pituitary-gonadal axis suppression during treatment was achieved in 16 of the 18 girls according to the clinical parameters and prepubertal LH levels. In these 16 well-controlled girls, the LH peak after a classical GnRH test was compared with a single LH measurement obtained 2 h after depot leuprolide acetate administration before and during GnRH analog treatment. Before therapy, the mean +/- SDLH peak after a classical GnRH test was 18.4 +/- 11.2 IU/liter ( ranging from 7 - 41.5 IU/liter), and it was 22.6 +/- 8.3 IU/liter 2 h after the first depot leuprolide dose ( ranging from 10 - 35.3 IU/liter). During therapy, the mean +/- SD of LH peak after classical GnRH test was 1.4 +/- 0.6 IU/liter ( ranging from < 0.6 to 2.3 IU/liter), and it was 2.7 +/- 1.9 IU/liter ( ranging from 0.7 - 6.6 IU/liter) 2 h after depot leuprolide. The LH peak after a classical GnRH test and that 2 h after depot leuprolide administration correlate significantly before and during treatment. In conclusion, we established the LH cut-off values for an adequate depot leuprolide therapy as an LH peak below 2.3 IU/liter after a classical GnRH test or below 6.6 IU/liter 2 h after depot leuprolide. The latter measurement may replace the classical GnRH test as a reliable and convenient tool for monitoring therapy in female gonadotropin-dependent precocious puberty.