Basal level of luteinizing hormone as a key marker of the idiopathic central hypogonadism in womenстатья
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Статья опубликована в журнале из списка Web of Science и/или Scopus
Дата последнего поиска статьи во внешних источниках: 24 февраля 2021 г.
Аннотация:Background: Central hypogonadism (CH) is a syndrome characterized by low levels of peripheral sex steroid hormones due to the lack of central(hypothalamic-pituitary) regulation of reproductive system. In females, CH clinically manifests by amenorrhea, anovulation, and infertility. The classical diagnostic criteria of CH in the absence of organic disease of hypothalamic-pituitary region (“idiopathic” CH) include low gonadotropin levels; however, their levels within the reference ranges do not exclude CH. Moreover, reference ranges for these parameters are different between laboratories. Thus, currently no clear laboratory diagnosticcriteria for female CH are available.Aim: To determine the diagnostic value of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) basal levels for the confirmation ofCH diagnosis in women and to identify cut-offs ofbasal gonadotropins levels, which can be considered as diagnostic criteria for female CH.Materials and methods: This cross-sectionalstudy included 87 women: 49 with confirmed CH,aged 18 to 36 years (median, 24 [Q21; Q29]), and38 healthy fertile women with regular menstrualcycles aged 21 to 45 years (median, 23 [Q23; Q28]). In all subjects, LH, FSH, estradiol, testosterone, prolactin, and free thyroxin levels were measured by chemiluminiscent immunoassay.Results: LH, FSH, estradiol, and prolactin levelsin the CH patients were significantly lowerthan those in healthy subjects. The ROC analysisshowed that LH level ≤ 1.95 ME/l indicated thecentral genesis of hypogonadism with sensitivityof 81.25% and specificity of 91.89%. Basal FSH level ≤ 5.075 ME/l had a 70.00% sensitivity and 77.14% specificity for CH diagnosis.Conclusion: Basal LH level ≤ 1.95 ME/l measuredby chemiluminiscent immunoassay can be consideredas an idiopathic CH diagnostic criterionin female with amenorrhea due to the hypoestrogenemia with sensitivity of > 80% and specificity > 90%.