{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:27:43Z","timestamp":1787509663110,"version":"build-2736575974"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Endocrine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Precocious puberty (PP) in girls is defined by thelarche before age 8. The diagnostic gold standard is an increased LH level following gonadotropin-releasing hormone (GnRH) stimulation. Alternatively, GnRH analogues like triptorelin can be used, though their interpretation varies. Since 2000, we have used a triptorelin-induced LH cut-off of 15\u2009IU\/L, 4\u2009h post-stimulus. However, many girls showed LH values below this threshold despite evident pubertal progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To establish a new LH threshold post-triptorelin stimulation for earlier diagnosis of central precocious puberty (CPP) in girls showing pubertal progression and to evaluate additional parameters for diagnostic accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled 186 girls with thelarche onset between ages 1\u20138 and a GnRH analogue assay performed between 2015\u20132019 without signs of axis activation. Within this cohort, 62 patients repeated the triptorelin test due to rapid pubertal progression. The assay involved administering 100\u2009mcg\/m\u00b2 of triptorelin and measuring LH, FSH, and estradiol levels before and four hours post-injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with axis activation at the second test had significantly higher post-stimulus LH levels at the first test compared to those below 15 IU\/L. They also had higher basal LH levels, elevated LH\/FSH ratio, and increased growth velocity. Statistical analysis identified a new post-stimulus LH threshold of 5 IU\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We propose a LH value of 5\u2009IU\/L after triptorelin administration as a new threshold for early CPP diagnosis. While the LH\/FSH ratio and growth velocity are associated with axis activation, they did not significantly enhance diagnostic accuracy when combined with the LH value.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12020-024-04055-0","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T08:02:19Z","timestamp":1728460939000},"page":"842-849","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Revising LH cut-off for the diagnosis of central precocious puberty via triptorelin stimulation assay"],"prefix":"10.1007","volume":"87","author":[{"given":"Paolo","family":"Cavarzere","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Sandri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Arrigoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Guardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Gaudino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Antoniazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"4055_CR1","doi-asserted-by":"publisher","unstructured":"E.L. Zevin, E.A. Eugster, Central precocious puberty: a review of diagnosis, treatment, and outcomes. Lancet Child Adolesc Health. (2023) https:\/\/doi.org\/10.1016\/S2352-4642(23)00237-7","DOI":"10.1016\/S2352-4642(23)00237-7"},{"key":"4055_CR2","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1136\/adc.44.235.291","volume":"44","author":"WA Marshall","year":"1969","unstructured":"W.A. Marshall, J.M. Tanner, Variations in pattern of pubertal changes in girls. Arch Dis Child 44, 291\u2013303 (1969). https:\/\/doi.org\/10.1136\/adc.44.235.291","journal-title":"Arch Dis Child"},{"key":"4055_CR3","unstructured":"M.M. Grumbach, D.M Styne, Puberty: ontogeny, neuroendocrinology, physiology. In: Williams Textbook of Endocrinology (Twelfth Edition), 1054-1201 (1998)"},{"key":"4055_CR4","doi-asserted-by":"publisher","unstructured":"P. Kaplowitz, C Bloch, Evaluation and referral of children with signs of early puberty. Pediatrics. 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Arcari, M.G. Ballerini, I. Bergad\u00e1, et al. High diagnostic accuracy of subcutaneous Triptorelin test compared with GnRH test for diagnosing central precocious puberty in girls. Clin Endocrinol (2000) https:\/\/doi.org\/10.1111\/j.1365-2265.2012.04517.x","DOI":"10.1111\/j.1365-2265.2012.04517.x"},{"key":"4055_CR8","doi-asserted-by":"publisher","unstructured":"Y.J. Kim, J. Hwangbo, K.H. Park, E. Kang, H.K. Nam, Y.J. Rhie, et al. Effectiveness of the triptorelin stimulation test compared with the classic gonadotropin-releasing hormone stimulation test in diagnosing central precocious puberty in girls. Ann Pediatr Endocrinol Metab. (2024) https:\/\/doi.org\/10.6065\/apem.2346054.027","DOI":"10.6065\/apem.2346054.027"},{"key":"4055_CR9","doi-asserted-by":"publisher","unstructured":"L. Iughetti, B. Predieri, M. Ferrari, et al. Diagnosis of central precocious puberty: endocrine assessment. J Pediatr Endocrinol Metab. 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The Institutional Ethics Committee of the province of Verona, Italy, took note of the retrospective conduct of the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}