Abstract
The Basal (B) on GnRH (P) stimulated levels of LH and FSH were measured by ultrasen sitive (0.4 and 0.3 mUI/ml) IRMA (CIS International) assay in 54 normal children: pre pubertal (PP n=24 (M 11, F 13); Early Pubertal (EP) n=17 (M9, F8); Advanced Pubertal (AP) n=13 (M8, F5). 10 patients (M8, F2) with DP {Tanner I, test vol.< 3, CA: n ± SD: 13.84 ± 1.14 y, BA: 11.94 ± 0.47 y) and 9 patients with HH (Tanner I, test vol <3, CA: 17.21 ± 3.23 y, BA: 13.87 ± 0.97 y) were also investigated. Ultrasensitive LH and FSH (0.04 and 0.04 mUI/ml) IFMA (Delfia) were assayed in a subgroup of 29 of the normal children. Across the entire range of pubertal sample LH and FSH, and also in the range PP, FSH values derived from the IRMA and IFMA were highly correlated (r = 0.97). In the B PP range LH not correlated (R = 0.27). In PP, B LH was undetectable by IRMA in 19 of the 24 and in 4 of the 11 by IFMA. B LH rose significantly with the onset of puberty. However, was in the range of PP in 7 of 17 by IRMA and 2 of 7 by IFMA. By AP every child had> 2 mUI/ml values. B FSH levels was detectable in all the groups and was significantly (p< 0.03) greater in F than in M in PP. Upon GnRH test, the distinction between the groups was better. P LH x ± DS PP: 2.93 ± 0.94 vs EP: 10.34 ± 4.93 (P< 0.0001) vs AP: 21.8 ± 8.98 mUI/ml (p<0.0001). No statically difference was found between IRMA or IFMA. All of the PP, F and M, had a ratio P LH to P FSH which was less than 1 and increased significantly with pubertal onset. In DP, before the appearance of pubertal signs, at BA 11.94 ± 0.47 y, the LH response to the Gn RH was 10.40 ± 4.60 vs 2.61 ± 2.14 mUI/ml (p <0.0001) in HH. LH responses did not overlap in either group. We conclude, that the test of Gn RH using gonadotropin ultrasensitive assay is useful in identifying the onset of puberty, and in the discrimination of DP from HH.
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Stivel, M., Arias, G., Campeni, S. et al. LH AND FSH TO GnRH ASSESED BY TWO HIGHLY SENSITIVE ASSAYS IN NORMAL PUBERTY, DELAYED PUBERTY (DP) AND HYPOCONADOTROPIC HYPOGONADISM (HH). Pediatr Res 33 (Suppl 5), S88 (1993). https://doi.org/10.1203/00006450-199305001-00511
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DOI: https://doi.org/10.1203/00006450-199305001-00511