성조숙증 여아들의 임상적 특징 및 진단별 성선자극호르몬 분비호르몬 GnRH (Gonado Tropin Releasing Hormone) 검사결과의 비교분석평가

• 영문명: Clinical Characteristics of precocious puberty girls and Comparison Analysis of GnRH Test results with Diagnosis type
• 발행기관: 대한핵의학기술학회
• 저자명: 김정인(Jung-In Kim) 권원현(Won-Hyun Kwon) 문기춘(Ki-Choon Moon) 이인원(In-Won Lee)
• 간행물 정보: 『핵의학기술』Vol.20 No.2, 54~61쪽, 전체 8쪽
• 주제분류: 의약학 > 방사선과학
• 파일형태: PDF
• 발행일자: 2016.10.30

영문 초록

Purpose Precocious Puberty is defined as the development of secondary sexual characteristics in girls younger than 8 years, and boys 9 years. Cause premature closure of the epiphysis is a disease that eventually decreases the final adult height. In this study, we retrospectively analyzed to evaluate the diagnostic difference the GnRH (Gonado-tropin-releasing Hormone) stimulation test results with medical records of precocious puberty in girls. Materials and Methods From February 2015 to December 2015 it was enrolled in the girls 118 people who visited the Seoul National University Bundang Hospital, Pediatrics, Endocrinology Internal Medicine. True precocious puberty group (n=57), early puberty group (n=39), were divided into Premature thelarche (n=22) group. A Tanner stage, chronological age, bone age, height, body weight for each group was determined by examining the mean±standard deviation. GnRH test result was compared LH (Basal, 30 min, 45 min, 60 min), FSH (Basal, 30 min, 60 min) for each group, Each group LH, FSH Peak value distribution, the mean±standard deviation was calculated for the peak LH/LH basal ratio, peak LH/Peak FSH ratio. The significance probability (P-value) between the value of each third group was determined. Results The average height of the true precocious puberty group 131± 14.85, the mean weight was 28.80±4.93, the average chronological age 7.1± 0.81, the mean bone age was 9.9±0.9, The average height of early puberty group was 134±5.10, the average weight 28.50±4.43, the average chronological age 8.05±0.03, the mean bone age was 10.0±0.62, The average height of Premature thelarche 129±6,01, the average weight was 28.65 ± 5.98, the average chronological age 7.02 ± 0.58, the mean bone age was 8.04 ± 1.29. There was no significant difference when compared to the height and weight. There was a significant difference between the groups in the chronologic age and bone age difference (P <0.0002) True precocious puberty group showed peak LH levels at 30’(82.5%), 45’(12.3%), 60’(5.3%), in Peak FSH 30’(8.8%), 60’(91.2%). Early Puberty group showed high values in Peak LH at 30’(79.5%), 45’(17.9%), 60’(2.6%), in peak FSH levels at 30’(7.7%), 60’(92.32%). In Premature thelarche Group it showed the Peak LH levels at 30’(30%), 45’(59%), 60'(9.09%), Peak FSH levels at 30’(0%) 60’(100%). When compared with the The Peak LH/basal LH ratio, True precocious puberty group was 19.09 ± 17.15, early puberty group was 15.23±10.88, Premature thelarche group showed significant differences between the three groups as 4.93±4.36.(P <0.0001) LH Peak/FSH Peak ratio, true precocious puberty group was 1.222±0.77, early puberty group was 1.34±1.23, Premature thelarche group showed significant differences between the three groups as 0.3±0.09(P <0.0001) Conclusion In order to diagnose the true precocious puberty have a diagnostic value when the LH peak after GnRH stimulation is increased by more than two to three times compared to baseline or a predetermined level or more than 5~10 IU/L increases. GnRH Test is a test for a long time and the patient discomfort due to repeated blood sampling, but the hypothalamus-pituitary gland- gonad axis activity evaluate and is the most basic accurate test in the differential diagnosis of precocious puberty disorders.

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대상 및 방법

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키워드

chronologic age bone age true precocious puberty early puberty Premature thelarche