A single blood luteinizing hormone level of triptorelin stimulation test can diagnose hypothalamic-pituitary-gonadal axis activation in girls with high body mass index

BackgroundBody mass index (BMI) may influence peak luteinizing hormone (PLH) levels during gonadotropin releasing hormone (GnRH) or GnRH analogues stimulation testing. BMI effects should be considered when interpreting test results for pubertal disorders in girls with overweight/obesity, but few stu...

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Main Authors: Beilei Zeng, Yinyin Huang, Yuan Zhou, Ye Li, Panwang Huang, Zhuangjian Xu, Yaping Ma
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1629423/full
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author Beilei Zeng
Beilei Zeng
Yinyin Huang
Yinyin Huang
Yuan Zhou
Yuan Zhou
Ye Li
Ye Li
Panwang Huang
Panwang Huang
Zhuangjian Xu
Yaping Ma
Yaping Ma
author_facet Beilei Zeng
Beilei Zeng
Yinyin Huang
Yinyin Huang
Yuan Zhou
Yuan Zhou
Ye Li
Ye Li
Panwang Huang
Panwang Huang
Zhuangjian Xu
Yaping Ma
Yaping Ma
author_sort Beilei Zeng
collection DOAJ
description BackgroundBody mass index (BMI) may influence peak luteinizing hormone (PLH) levels during gonadotropin releasing hormone (GnRH) or GnRH analogues stimulation testing. BMI effects should be considered when interpreting test results for pubertal disorders in girls with overweight/obesity, but few studies have excluded it.MethodsThis was a hospital data-based retrospective study. Girls with puberty disorders who had been followed up for six months to two years were enrolled in the study. They were divided into the overweight/obesity group and the normal BMI group and all underwent triptorelin stimulation test. Blood samples were collected at 0 min before and 20, 40, and 60 min after the test. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) serum concentrations were quantified by immunochemiluminometric assay.ResultsA total of 422 girls who underwent 454 triptorelin stimulation tests were included in this study. Among 148 tests performed on 142 overweight/obesity girls, 110 tests were hypothalamic-pituitary-gonadal axis (HPGA) activated and 38 tests were HPGA non-activated. Among 306 tests performed on 284 girls with normal BMI, 214 tests were HPGA activated and 92 tests were non-activated. LH, FSH, and estradiol levels in girls whose HPGA activated were significantly higher than those non-activated. The area under the curves of LH20 min, LH40 min, LH60 min and PLH after triptorelin stimulation tests in girls with overweight/obesity for diagnosing HPGA activation were 0.996, 0.980, 0.990 and 0.994, respectively. There was no statistical significance in the area under the curves between LH20 min, LH40 min, LH60 min and PLH. When LH20 min, LH40 min, LH60 min and PLH were ≥3.26 IU/L, ≥4.09 IU/L, ≥4.27 IU/L and ≥4.51 IU/L, the sensitivity for diagnosing HPGA activation in girls with overweight/obesity were 99.03%, 95.45%, 98.18% and 97.27%, and the corresponding specificity were 94.59%, 97.37%, 100.00%, and 100.00%, respectively. The cut-off value of serum LH60 min after the triptorelin stimulation test for diagnosing HPGA activation in precocious pubertal girls with overweight/obesity was 4.45 IU/L, and in pubertal girls with overweight/obesity was 4.20 IU/L.ConclusionsLH measurements obtained at 20, 40, or 60 min post-triptorelin stimulation can diagnose HPGA activation in girls with high BMI.
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spelling doaj-art-f4595e107ee14bdd99ce2e6f2aca2ca52025-08-21T05:27:31ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-08-011310.3389/fped.2025.16294231629423A single blood luteinizing hormone level of triptorelin stimulation test can diagnose hypothalamic-pituitary-gonadal axis activation in girls with high body mass indexBeilei Zeng0Beilei Zeng1Yinyin Huang2Yinyin Huang3Yuan Zhou4Yuan Zhou5Ye Li6Ye Li7Panwang Huang8Panwang Huang9Zhuangjian Xu10Yaping Ma11Yaping Ma12Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, ChinaWuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, ChinaDepartment of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, ChinaWuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, ChinaDepartment of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, ChinaWuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, ChinaDepartment of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, ChinaWuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, ChinaDepartment of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, ChinaWuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, ChinaDepartment of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, ChinaDepartment of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, ChinaWuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, ChinaBackgroundBody mass index (BMI) may influence peak luteinizing hormone (PLH) levels during gonadotropin releasing hormone (GnRH) or GnRH analogues stimulation testing. BMI effects should be considered when interpreting test results for pubertal disorders in girls with overweight/obesity, but few studies have excluded it.MethodsThis was a hospital data-based retrospective study. Girls with puberty disorders who had been followed up for six months to two years were enrolled in the study. They were divided into the overweight/obesity group and the normal BMI group and all underwent triptorelin stimulation test. Blood samples were collected at 0 min before and 20, 40, and 60 min after the test. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) serum concentrations were quantified by immunochemiluminometric assay.ResultsA total of 422 girls who underwent 454 triptorelin stimulation tests were included in this study. Among 148 tests performed on 142 overweight/obesity girls, 110 tests were hypothalamic-pituitary-gonadal axis (HPGA) activated and 38 tests were HPGA non-activated. Among 306 tests performed on 284 girls with normal BMI, 214 tests were HPGA activated and 92 tests were non-activated. LH, FSH, and estradiol levels in girls whose HPGA activated were significantly higher than those non-activated. The area under the curves of LH20 min, LH40 min, LH60 min and PLH after triptorelin stimulation tests in girls with overweight/obesity for diagnosing HPGA activation were 0.996, 0.980, 0.990 and 0.994, respectively. There was no statistical significance in the area under the curves between LH20 min, LH40 min, LH60 min and PLH. When LH20 min, LH40 min, LH60 min and PLH were ≥3.26 IU/L, ≥4.09 IU/L, ≥4.27 IU/L and ≥4.51 IU/L, the sensitivity for diagnosing HPGA activation in girls with overweight/obesity were 99.03%, 95.45%, 98.18% and 97.27%, and the corresponding specificity were 94.59%, 97.37%, 100.00%, and 100.00%, respectively. The cut-off value of serum LH60 min after the triptorelin stimulation test for diagnosing HPGA activation in precocious pubertal girls with overweight/obesity was 4.45 IU/L, and in pubertal girls with overweight/obesity was 4.20 IU/L.ConclusionsLH measurements obtained at 20, 40, or 60 min post-triptorelin stimulation can diagnose HPGA activation in girls with high BMI.https://www.frontiersin.org/articles/10.3389/fped.2025.1629423/fullluteinizing hormonetriptorelin stimulation testgirlshypothalamic-pituitary-gonadal axishigh body mass index
spellingShingle Beilei Zeng
Beilei Zeng
Yinyin Huang
Yinyin Huang
Yuan Zhou
Yuan Zhou
Ye Li
Ye Li
Panwang Huang
Panwang Huang
Zhuangjian Xu
Yaping Ma
Yaping Ma
A single blood luteinizing hormone level of triptorelin stimulation test can diagnose hypothalamic-pituitary-gonadal axis activation in girls with high body mass index
Frontiers in Pediatrics
luteinizing hormone
triptorelin stimulation test
girls
hypothalamic-pituitary-gonadal axis
high body mass index
title A single blood luteinizing hormone level of triptorelin stimulation test can diagnose hypothalamic-pituitary-gonadal axis activation in girls with high body mass index
title_full A single blood luteinizing hormone level of triptorelin stimulation test can diagnose hypothalamic-pituitary-gonadal axis activation in girls with high body mass index
title_fullStr A single blood luteinizing hormone level of triptorelin stimulation test can diagnose hypothalamic-pituitary-gonadal axis activation in girls with high body mass index
title_full_unstemmed A single blood luteinizing hormone level of triptorelin stimulation test can diagnose hypothalamic-pituitary-gonadal axis activation in girls with high body mass index
title_short A single blood luteinizing hormone level of triptorelin stimulation test can diagnose hypothalamic-pituitary-gonadal axis activation in girls with high body mass index
title_sort single blood luteinizing hormone level of triptorelin stimulation test can diagnose hypothalamic pituitary gonadal axis activation in girls with high body mass index
topic luteinizing hormone
triptorelin stimulation test
girls
hypothalamic-pituitary-gonadal axis
high body mass index
url https://www.frontiersin.org/articles/10.3389/fped.2025.1629423/full
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