{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T15:45:44Z","timestamp":1784735144888,"version":"3.55.0"},"reference-count":36,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","award":["RC 32\/18"],"award-info":[{"award-number":["RC 32\/18"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard method for diagnosing central precocious puberty (CPP), although it requires multiple blood samplings over 120 min. This study aimed to evaluate if a shorter test may have an equivalent diagnostic accuracy. Materials and Methods: We retrospectively reviewed the GnRH tests of 188 consecutive pediatric patients (169 females) referred for signs of early pubertal development. The diagnostic accuracy of the hormonal levels was evaluated at different time points (15, 0, 60, 90, and 120 min after the GnRH stimulus). Results: A diagnosis of CPP was made in 130 cases (69%), with 111 (85%) being female. Sensitivity and specificity ratings higher than 99% for the diagnosis of CPP were achieved for LH levels \u22654.7 mU\/mL at 30 and 60 min after the stimulus (area under the ROC curve (AUC) = 1), with no further increase in the diagnostic accuracy in the remaining time points. No sex differences in diagnostic accuracy were found. The LH\/FSH ratio at 30 min showed a sensitivity of 94.9%, with an AUC of 0.997 and a value \u22650.76. Conclusions: A short-duration GnRH test of 60 min provided optimal results for the diagnosis of CPP. Extending the test for an extra hour is therefore unnecessary and inadvisable.<\/jats:p>","DOI":"10.3390\/medicina60010024","type":"journal-article","created":{"date-parts":[[2023,12,24]],"date-time":"2023-12-24T20:44:15Z","timestamp":1703450655000},"page":"24","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A Short-Duration Gonadotropin-Releasing Hormone Stimulation Test for the Diagnosis of Central Precocious Puberty"],"prefix":"10.3390","volume":"60","author":[{"given":"Maria Chiara","family":"Pellegrin","sequence":"first","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Marzin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7774-548X","authenticated-orcid":false,"given":"Lorenzo","family":"Monasta","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1635-9141","authenticated-orcid":false,"given":"Gianluca","family":"Tamaro","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"Vidonis","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Vittori","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Faleschini","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6343-846X","authenticated-orcid":false,"given":"Egidio","family":"Barbi","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34129 Trieste, Italy"},{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4395-3915","authenticated-orcid":false,"given":"Gianluca","family":"Tornese","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34129 Trieste, Italy"},{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2366","DOI":"10.1056\/NEJMcp0800459","article-title":"Clinical practice. Precocious puberty","volume":"358","author":"Carel","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1111\/cen.14475","article-title":"Central precocious puberty: Recent advances in understanding the aetiology and in the clinical approach","volume":"4","author":"Maione","year":"2021","journal-title":"Clin. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"580588","DOI":"10.3389\/fped.2020.580588","article-title":"Pattern and Features of Pediatric Endocrinology Referrals: A Retrospective Study in a Single Tertiary Center in Italy","volume":"8","author":"Bellotto","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1159\/000232164","article-title":"Subcutaneous gonadotropin-releasing hormone agonist (triptorelin) test for diagnosing precocious puberty","volume":"72","author":"Poomthavorn","year":"2009","journal-title":"Horm. Res. Paediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1001\/archpedi.1994.02170040035006","article-title":"Laboratory monitoring of children with precocious puberty","volume":"148","author":"Lee","year":"1994","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_6","first-page":"30","article-title":"Use of leuprolide acetate response patterns in the early diagnosis of pubertal disorders: Comparison with the gonadotropin-releasing hormone test","volume":"78","author":"Potau","year":"1994","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e1059","DOI":"10.1542\/peds.2008-1180","article-title":"Adequacy of a single unstimulated luteinizing hormone level to diagnose central precocious puberty in girls","volume":"123","author":"Houk","year":"2009","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/S0022-3476(95)70255-5","article-title":"Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty","volume":"127","author":"Neely","year":"1995","journal-title":"J. Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1210\/jcem-67-3-474","article-title":"Premature thelarche and central precocious puberty: The relationship between clinical presentation and the gonadotropin response to luteinizing hormone-releasing hormone","volume":"67","author":"Pescovitz","year":"1988","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1111\/j.1365-2265.1995.tb02692.x","article-title":"A simplified gonadotrophin-releasing hormone test for precocious puberty","volume":"42","author":"Cavallo","year":"1995","journal-title":"Clin. Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"152","DOI":"10.6065\/apem.2040004.002","article-title":"Gonadotropin-releasing hormone stimulation test and diagnostic cutoff in precocious puberty: A mini review","volume":"25","author":"Omar","year":"2020","journal-title":"Ann. Pediatr. Endocrinol. Metab."},{"key":"ref_12","first-page":"1353","article-title":"Treatment of central precocious puberty: Comparison of urinary gonadotropin excretion and gonadotropin-releasing hormone (GnRH) stimulation tests in monitoring GnRH analog therapy","volume":"81","author":"Witchel","year":"1996","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1515\/JPEM.2008.21.12.1113","article-title":"The diagnostic value of a brief GnRH analogue stimulation test in girls with central precocious puberty: A single 30-minute post-stimulation LH sample is adequate","volume":"21","author":"Houk","year":"2008","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_14","first-page":"244","article-title":"Gonadotropin-releasing hormone stimulation test for precocious puberty","volume":"31","author":"Kim","year":"2011","journal-title":"Korean J. Lab. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1303989","DOI":"10.3389\/fendo.2023.1303989","article-title":"Prevalence and characteristics of thelarche variant","volume":"14","author":"Burlo","year":"2023","journal-title":"Front. Endocrinol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"400","DOI":"10.4103\/2230-8210.95682","article-title":"Evaluation of GnRH analogue testing in diagnosis and management of children with pubertal disorders","volume":"16","author":"Prasad","year":"2012","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/BF03344156","article-title":"Italian cross-sectional growth charts for height, weight and BMI (2 to 20 yr)","volume":"29","author":"Cacciari","year":"2006","journal-title":"J. Endocrinol. Investig."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1136\/adc.51.3.170","article-title":"Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty","volume":"51","author":"Tanner","year":"1976","journal-title":"Arch. Dis. Child."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Greulich, W.W., and Pyle, S.I. (1959). Radiographic Atlas of Skeletal Development of the Hand and Wrist, Stanford University Press. [2nd ed.].","DOI":"10.1097\/00000441-195909000-00030"},{"key":"ref_20","unstructured":"The Italian Data Protection Authority (2023, November 15). Authorisation No. 9\/2014\u2014General Authorisation to Process Personal Data for Scientific Research Purposes. Available online: https:\/\/www.garanteprivacy.it\/web\/guest\/home\/docweb\/-\/docweb-display\/docweb\/3786078."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kang, S., Park, M.J., Kim, J.M., Yuk, J.S., and Kim, S.H. (2023). Ongoing increasing trends in central precocious puberty incidence among Korean boys and girls from 2008 to 2020. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0283510"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"bvad094","DOI":"10.1210\/jendso\/bvad094","article-title":"Precocious Puberty Diagnoses Spike, COVID-19 Pandemic, and Body Mass Index: Findings From a 4-year Study","volume":"7","author":"Fava","year":"2023","journal-title":"J. Endocr. Soc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s13052-022-01238-1","article-title":"Reduction in pediatric growth hormone deficiency and increase in central precocious puberty diagnoses during COVID 19 pandemics","volume":"48","author":"Peinkhofer","year":"2022","journal-title":"Ital. J. Pediatr."},{"key":"ref_24","first-page":"1","article-title":"A single sample GnRHa stimulation test in the diagnosis of precocious puberty","volume":"23","author":"Yazdani","year":"2012","journal-title":"Int. J. Pediatr. Endocrinol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1007\/s12020-021-02947-z","article-title":"Triptorelin stimulated luteinizing hormone concentrations for diagnosing central precocious puberty: Study of diagnostic accuracy","volume":"75","author":"Vukovic","year":"2022","journal-title":"Endocrine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"713880","DOI":"10.3389\/fendo.2021.713880","article-title":"The Diagnostic Utility of the Basal Luteinizing Hormone Level and Single 60-Minute Post GnRH Agonist Stimulation Test for Idiopathic Central Precocious Puberty in Girls","volume":"12","author":"Cao","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1080\/17446651.2019.1575726","article-title":"Update on central precocious puberty: From etiologies to outcomes","volume":"14","author":"Eugster","year":"2019","journal-title":"Expert Rev. Endocrinol. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1111\/cen.14578","article-title":"Interpretation of reproductive hormones before, during and after the pubertal transition-Identifying health and disordered puberty","volume":"95","author":"Howard","year":"2021","journal-title":"Clin. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"164","DOI":"10.6065\/apem.2019.24.3.164","article-title":"Basal serum luteinizing hormone value as the screening biomarker in female central precocious puberty","volume":"24","author":"Heo","year":"2019","journal-title":"Ann. Pediatr. Endocrinol. Metab."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"27","DOI":"10.6065\/apem.2019.24.1.27","article-title":"Morning basal luteinizing hormone, a good screening tool for diagnosing central precocious puberty","volume":"24","author":"Lee","year":"2019","journal-title":"Ann. Pediatr. Endocrinol. Metab."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4274\/jcrpe.v3i1.03","article-title":"GnRH stimulation test in precocious puberty: Single sample is adequate for diagnosis and dose adjustment","volume":"3","author":"Kandemir","year":"2011","journal-title":"J. Clin. Res. Pediatr. Endocrinol."},{"key":"ref_32","first-page":"387","article-title":"Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls","volume":"28","author":"Chin","year":"2015","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1515\/jpem-2017-0124","article-title":"Evaluation of basal sex hormone levels for activation of the hypothalamic-pituitary-gonadal axis","volume":"31","author":"Ding","year":"2018","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"660692","DOI":"10.3389\/fendo.2021.660692","article-title":"Should Pediatric Endocrinologists Consider More Carefully When to Perform a Stimulation Test?","volume":"12","author":"Penco","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3389\/fendo.2017.00213","article-title":"Precocious Puberty or Premature Thelarche: Analysis of a Large Patient Series in a Single Tertiary Center with Special Emphasis on 6- to 8-Year-Old Girls","volume":"8","author":"Varimo","year":"2017","journal-title":"Front. Endocrinol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1590\/S0004-27302008000100005","article-title":"Update on the etiology, diagnosis and therapeutic management of sexual precocity","volume":"52","author":"Brito","year":"2008","journal-title":"Arq. Bras. Endocrinol. Metabol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/1\/24\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:40:44Z","timestamp":1760132444000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/1\/24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,22]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["medicina60010024"],"URL":"https:\/\/doi.org\/10.3390\/medicina60010024","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,22]]}}}