Correlation of Preinjection Values of Gonadotropins and Estradiol Level with Clinical and Radiologic Evidence of Sufficient Pubertal Suppression in Girls with Central Precocious Puberty

Background: In monitoring of precocious puberty treatment, less attention has been paid to the clinical signs and radiological evidence of puberty control. We evaluated the correlation of preinjection values of gonadotropins and estradiol level with clinical criteria of sufficient pubertal suppression in girls with central precocious puberty. Materials and Methods: 34 patients with CPP were included. After 4-19 dose of depot Triptorelin, blood levels of Estradiol, LH and FSH was measured before next dose of drug. The growth velocity and the bone age advancement were calculated. Correlation of Estradiol and gonadotropins level with clinical and radiologic evidences of pubertal suppression determined. Results: The mean age was 8.82±1.31 years. The mean LH ± SD was 1.02 ±0.53 IU/l (range 0.1-3.55 IU/l). LH/FSH ratio was 0.85±1.3 and 7 girls (20.5%) has LH/FSH ratio above 1. Serum LH level had significant correlation only with FSH (R = 0.589, P< 0.0001). The physical symptoms of puberty (breast tanner stage) were regressed well in 22 (52.9%) but in 12 (47.1%) cases were partially inhibited. Insufficient inhibition of physical signs of puberty was associated with higher growth rate of height (R: 0.422, P = 0.013) and higher BMI-SDS (R: -0.423, P: 0.008). Conclusion: A preinjection value of gonadotropins and estradiol level has not correlation with other criteria of sufficient pubertal suppression in girls with central precocious puberty and is not useful for monitoring of treatment.