Limits...
Urinary gonadotrophins: a useful non-invasive marker of activation of the hypothalamic pituitary-gonadal axis.

McNeilly JD, Mason A, Khanna S, Galloway PJ, Ahmed SF - Int J Pediatr Endocrinol (2012)

Bottom Line: LH:Creatinine ratios were significantly higher in pubertal compared to pre-pubertal boys (p<0.001).In girls, FSH:Creatinine ratios were significantly higher in the pubertal group (p = 0.006).Urinary gonadotrophins analyses could be used as non-invasive integrated measurement of pubertal status which reflects clinical/physical status.

View Article: PubMed Central - HTML - PubMed

Affiliation: Developmental Endocrinology Research Group, Royal Hospital for Sick Children, Glasgow, UK. Faisal.Ahmed@glasgow.ac.uk.

ABSTRACT

Background: Non-invasive screening investigations are rarely used for assessing the activation and progression of the hypothalamic-pituitary gonadal axis through puberty. This study aimed to establish a normal range for urinary gonadotrophins in children progressing through puberty.

Methods: Urine samples were collected from 161 healthy school children (76 boys, 85 girls) aged 4-19 yrs. Height and weight were converted to standard deviation score. Pubertal status, classified by Tanner staging, was determined by self-assessment. Urinary gonadotrophins were measured by chemiluminescent microparticle immunoassay. Results were grouped according to pubertal status (pre-pubertal or pubertal).

Results: Of the 161 children, 50 were pre-pubertal (28 boys; 22 girls) and 111 were pubertal (48 boys; 63 girls). Overall, urinary gonadotrophins concentrations increased with pubertal maturation. All pre-pubertal children had a low urinary LH:Creatinine ratio. LH:Creatinine ratios were significantly higher in pubertal compared to pre-pubertal boys (p<0.001). In girls, FSH:Creatinine ratios were significantly higher in the pubertal group (p = 0.006). However, LH:FSH ratios were a more consistent discriminant between pre-pubertal and pubertal states in both sexes (Boys 0.45 pubertal vs 0.1 pre-pubertal; girls 0.23 pubertal vs 0.06 pre-pubertal).

Conclusion: Urinary gonadotrophins analyses could be used as non-invasive integrated measurement of pubertal status which reflects clinical/physical status.

No MeSH data available.


Related in: MedlinePlus

a-c - Urinary gonadotrophins grouped according to pubertal status. a) Median LH:Creatinine, b) FSH:Creatinine and c) LH:FSH ratios grouped according to pubertal status. The box and whisker plots represent the median (heavy line), interquartile (box) and range (whiskers).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3420251&req=5

Figure 1: a-c - Urinary gonadotrophins grouped according to pubertal status. a) Median LH:Creatinine, b) FSH:Creatinine and c) LH:FSH ratios grouped according to pubertal status. The box and whisker plots represent the median (heavy line), interquartile (box) and range (whiskers).

Mentions: Of the original 161 samples, 113 (70%) had measurable LH and FSH. LH was undetectable (<0.1 IU/L) in 46 samples (20 boys; 26 girls) with only 2 samples (girls) having undetectable FSH (<0.1 IU/L). None of the samples were regarded too dilute for analysis (creatinine < 1.0 mmol/L). Overall, the median levels of urinary gonadotrophins increased with pubertal maturation. All pre-pubertal children had very low LH:Cr ratio with little spread (median LH:Cr; boys 0.01 (centiles 0.0, 0.10), girls 0.03 (0.01, 0.85) (Figure 1a). A significant difference between pre-pubertal and pubertal LH:Cr ratio was observed in boys with those in puberty having higher LH concentrations (median LH:Cr; pre-pubertal 0.01 (0.0, 0.10), pubertal 0.09 (0.02, 0.24) p< 0.001; Figure 1a). A similar pattern was seen in girls but the difference was not significant (median LH:Cr; pre-pubertal 0.03 (0.01, 0.85), pubertal 0.11 (0.11, 0.52) p< 0.16; Figure 1a). Urinary FSH:Cr ratios showed a similar pattern with ratios being higher in children undergoing puberty (Figure 1b). The FSH:Cr ratio was higher in pubertal than pre-pubertal girls (median FSH:Cr; pre-pubertal 0.19 (0.10, 0.65) vs pubertal 0.45 (0.14, 1.19); p =  0.006 Figure 1b). There was, however, no significant difference in FSH:Cr ratio between the pre-pubertal and pubertal boys (p = 0.079). Urinary LH:FSH ratio clearly differentiated between physically pre-pubertal and pubertal children (Figure 1c). The LH:FSH ratio was higher in the pubertal than in pre-pubertal group in both sexes, reaching significance in boys (median LH:FSH pre-pubertal 0.1 (0.05, 0.37) vs pubertal 0.45 (0.14, 1.00); p = 0.001) but not girls (median LH:FSH pre-pubertal 0.06 (0.02, 0.61) vs pubertal 0.23 (0.05, 0.53); p = 0.067).


Urinary gonadotrophins: a useful non-invasive marker of activation of the hypothalamic pituitary-gonadal axis.

McNeilly JD, Mason A, Khanna S, Galloway PJ, Ahmed SF - Int J Pediatr Endocrinol (2012)

a-c - Urinary gonadotrophins grouped according to pubertal status. a) Median LH:Creatinine, b) FSH:Creatinine and c) LH:FSH ratios grouped according to pubertal status. The box and whisker plots represent the median (heavy line), interquartile (box) and range (whiskers).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3420251&req=5

Figure 1: a-c - Urinary gonadotrophins grouped according to pubertal status. a) Median LH:Creatinine, b) FSH:Creatinine and c) LH:FSH ratios grouped according to pubertal status. The box and whisker plots represent the median (heavy line), interquartile (box) and range (whiskers).
Mentions: Of the original 161 samples, 113 (70%) had measurable LH and FSH. LH was undetectable (<0.1 IU/L) in 46 samples (20 boys; 26 girls) with only 2 samples (girls) having undetectable FSH (<0.1 IU/L). None of the samples were regarded too dilute for analysis (creatinine < 1.0 mmol/L). Overall, the median levels of urinary gonadotrophins increased with pubertal maturation. All pre-pubertal children had very low LH:Cr ratio with little spread (median LH:Cr; boys 0.01 (centiles 0.0, 0.10), girls 0.03 (0.01, 0.85) (Figure 1a). A significant difference between pre-pubertal and pubertal LH:Cr ratio was observed in boys with those in puberty having higher LH concentrations (median LH:Cr; pre-pubertal 0.01 (0.0, 0.10), pubertal 0.09 (0.02, 0.24) p< 0.001; Figure 1a). A similar pattern was seen in girls but the difference was not significant (median LH:Cr; pre-pubertal 0.03 (0.01, 0.85), pubertal 0.11 (0.11, 0.52) p< 0.16; Figure 1a). Urinary FSH:Cr ratios showed a similar pattern with ratios being higher in children undergoing puberty (Figure 1b). The FSH:Cr ratio was higher in pubertal than pre-pubertal girls (median FSH:Cr; pre-pubertal 0.19 (0.10, 0.65) vs pubertal 0.45 (0.14, 1.19); p =  0.006 Figure 1b). There was, however, no significant difference in FSH:Cr ratio between the pre-pubertal and pubertal boys (p = 0.079). Urinary LH:FSH ratio clearly differentiated between physically pre-pubertal and pubertal children (Figure 1c). The LH:FSH ratio was higher in the pubertal than in pre-pubertal group in both sexes, reaching significance in boys (median LH:FSH pre-pubertal 0.1 (0.05, 0.37) vs pubertal 0.45 (0.14, 1.00); p = 0.001) but not girls (median LH:FSH pre-pubertal 0.06 (0.02, 0.61) vs pubertal 0.23 (0.05, 0.53); p = 0.067).

Bottom Line: LH:Creatinine ratios were significantly higher in pubertal compared to pre-pubertal boys (p<0.001).In girls, FSH:Creatinine ratios were significantly higher in the pubertal group (p = 0.006).Urinary gonadotrophins analyses could be used as non-invasive integrated measurement of pubertal status which reflects clinical/physical status.

View Article: PubMed Central - HTML - PubMed

Affiliation: Developmental Endocrinology Research Group, Royal Hospital for Sick Children, Glasgow, UK. Faisal.Ahmed@glasgow.ac.uk.

ABSTRACT

Background: Non-invasive screening investigations are rarely used for assessing the activation and progression of the hypothalamic-pituitary gonadal axis through puberty. This study aimed to establish a normal range for urinary gonadotrophins in children progressing through puberty.

Methods: Urine samples were collected from 161 healthy school children (76 boys, 85 girls) aged 4-19 yrs. Height and weight were converted to standard deviation score. Pubertal status, classified by Tanner staging, was determined by self-assessment. Urinary gonadotrophins were measured by chemiluminescent microparticle immunoassay. Results were grouped according to pubertal status (pre-pubertal or pubertal).

Results: Of the 161 children, 50 were pre-pubertal (28 boys; 22 girls) and 111 were pubertal (48 boys; 63 girls). Overall, urinary gonadotrophins concentrations increased with pubertal maturation. All pre-pubertal children had a low urinary LH:Creatinine ratio. LH:Creatinine ratios were significantly higher in pubertal compared to pre-pubertal boys (p<0.001). In girls, FSH:Creatinine ratios were significantly higher in the pubertal group (p = 0.006). However, LH:FSH ratios were a more consistent discriminant between pre-pubertal and pubertal states in both sexes (Boys 0.45 pubertal vs 0.1 pre-pubertal; girls 0.23 pubertal vs 0.06 pre-pubertal).

Conclusion: Urinary gonadotrophins analyses could be used as non-invasive integrated measurement of pubertal status which reflects clinical/physical status.

No MeSH data available.


Related in: MedlinePlus