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Comparison of detection of normal puberty in boys by a hormonal sleep test and a gonadotropin-releasing hormone agonist test.
- Source :
-
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2012 Dec; Vol. 97 (12), pp. 4596-604. Date of Electronic Publication: 2012 Oct 05. - Publication Year :
- 2012
-
Abstract
- Context: The magnitude of sleep-related gonadotropin rise required to activate pubertal gonadal function is not established.<br />Objective: Our objective was to determine the normal relationship between sleep-related pubertal hormone levels and pituitary-testicular responsiveness to a GnRH agonist (GnRHag) test across the pubertal transition. DESIGN/SETTING AND PARTICIPANTS: We conducted a prospective study in a General Clinical Research Center with healthy 9- to 15-yr-old volunteer boys.<br />Interventions: INTERVENTIONS included overnight blood sampling followed by leuprolide acetate injection (10 μg/kg).<br />Primary Outcome Variables: LH, FSH, and testosterone levels were evaluated.<br />Results: LH levels during sleep and post-GnRHag rose steadily during the late prepubertal years. Sleep peak LH correlated highly with the LH response to GnRHag across groups (r = 0.913). A sleep peak LH level of at least 3.7 U/liter predicted pubertal testicular activation with 100% accuracy. LH of at least 14.8 and at least 19.0 U/liter 4 h after GnRHag, respectively, predicted puberty with 100% sensitivity/94% specificity and 100% specificity/94% sensitivity. Overweight pubertal boys had transiently prolonged responses to GnRHag. FSH rose during both waking and sleeping hours during the prepubertal years, and all pubertal boys had an FSH level of at least 0.9 U/liter awake and at least 1.2 U/liter asleep. Sleep LH was more closely related than FSH to testicular size.<br />Conclusions: These data suggest that a critical LH level during sleep (≥3.7 U/liter) heralds the onset of pubertal virilization and that this level is predictable by LH of at least 14.8-19 U/liter 4 h after GnRHag. These data also suggest that LH stimulation of testicular androgen production plays a role in stimulating testicular tubule growth once a critical level of FSH is achieved.
- Subjects :
- Adiposity physiology
Adolescent
Child
Follicle Stimulating Hormone blood
Gonadotropins metabolism
Humans
Luteinizing Hormone blood
Male
Overweight blood
Overweight metabolism
Overweight physiopathology
Polysomnography statistics & numerical data
Research Design
Testosterone blood
Diagnostic Techniques, Endocrine
Gonadotropin-Releasing Hormone agonists
Gonadotropins blood
Puberty blood
Puberty metabolism
Sleep physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1945-7197
- Volume :
- 97
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 23043188
- Full Text :
- https://doi.org/10.1210/jc.2012-2722