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Published in: International Journal of Pediatric Endocrinology 1/2012

Open Access 01-12-2012 | Research

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

Authors: Jane D McNeilly, Avril Mason, Sheila Khanna, Peter J Galloway, S Faisal Ahmed

Published in: International Journal of Pediatric Endocrinology | Issue 1/2012

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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.
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Literature
1.
go back to reference Fitchen W, Clayton BE: Urinary excretion of gonadotrophins with particular reference to children. Arch Dis Child. 1965, 40: 16-26. 10.1136/adc.40.209.16.CrossRef Fitchen W, Clayton BE: Urinary excretion of gonadotrophins with particular reference to children. Arch Dis Child. 1965, 40: 16-26. 10.1136/adc.40.209.16.CrossRef
2.
go back to reference Rifkind AB, Kulin HE, Ross GT: Follicle-stimulating hormone (FSH) and luteninizing hormone (LH) in the urine of prepubertal children. J Clin Invest. 1967, 46: 1925-31. 10.1172/JCI105682.PubMedCentralCrossRefPubMed Rifkind AB, Kulin HE, Ross GT: Follicle-stimulating hormone (FSH) and luteninizing hormone (LH) in the urine of prepubertal children. J Clin Invest. 1967, 46: 1925-31. 10.1172/JCI105682.PubMedCentralCrossRefPubMed
3.
go back to reference Demir A, Dunkel L, Stenman UH, Voutilainen R: Age-related course of urinary gonadotropins in children. J Clin Endocrinol Metab. 1995, 80: 1457-60. 10.1210/jc.80.4.1457.PubMed Demir A, Dunkel L, Stenman UH, Voutilainen R: Age-related course of urinary gonadotropins in children. J Clin Endocrinol Metab. 1995, 80: 1457-60. 10.1210/jc.80.4.1457.PubMed
4.
go back to reference Zhang K, Pollack S, Ghods A, Dicken C, Isaac B, Adel G, Zeitlian G, Santoro N: Onset of ovulation after menarche in girls: a longitudinal study. J Clin Endocrinol Metab. 2008, 93: 1186-94. 10.1210/jc.2007-1846.PubMedCentralCrossRefPubMed Zhang K, Pollack S, Ghods A, Dicken C, Isaac B, Adel G, Zeitlian G, Santoro N: Onset of ovulation after menarche in girls: a longitudinal study. J Clin Endocrinol Metab. 2008, 93: 1186-94. 10.1210/jc.2007-1846.PubMedCentralCrossRefPubMed
5.
go back to reference Kuijper EA, Houwink EJ, van Weissenbruch MM, Heij HA, Blankenstein MA, Huijser J, Martens F, Lambalk CB: Urinary gonadotropin measurements in neonates: a valuable non-invasive method. Ann Clin Biochem. 2006, 43: 320-2. 10.1258/000456306777695582.CrossRefPubMed Kuijper EA, Houwink EJ, van Weissenbruch MM, Heij HA, Blankenstein MA, Huijser J, Martens F, Lambalk CB: Urinary gonadotropin measurements in neonates: a valuable non-invasive method. Ann Clin Biochem. 2006, 43: 320-2. 10.1258/000456306777695582.CrossRefPubMed
6.
go back to reference Maqsood AR, Trueman JA, Whatmore AJ, Westwood M, Price DA, Hall CM, Clayton PE: The relationship between nocturnal urinary leptin and gonadotrophins as children progress towards puberty. Horm Res. 2007, 68: 225-30. 10.1159/000101335.CrossRefPubMed Maqsood AR, Trueman JA, Whatmore AJ, Westwood M, Price DA, Hall CM, Clayton PE: The relationship between nocturnal urinary leptin and gonadotrophins as children progress towards puberty. Horm Res. 2007, 68: 225-30. 10.1159/000101335.CrossRefPubMed
7.
go back to reference Demir A, Alfthan H, Stenman UH, Voutilainen R: A clinically useful method for detecting gonadotropins in children: assessment of luteinizing hormone and follicle-stimulating hormone from urine as an alternative to serum by ultrasensitive time-resolved immunofluorometric assays. Pediatr Res. 1994, 36: 221-6. 10.1203/00006450-199408000-00014.CrossRefPubMed Demir A, Alfthan H, Stenman UH, Voutilainen R: A clinically useful method for detecting gonadotropins in children: assessment of luteinizing hormone and follicle-stimulating hormone from urine as an alternative to serum by ultrasensitive time-resolved immunofluorometric assays. Pediatr Res. 1994, 36: 221-6. 10.1203/00006450-199408000-00014.CrossRefPubMed
8.
go back to reference Demir A, Voutilainen R, Juul A, Dunkel L, Alfthan H, Skakkebaek NE, Stenman UH: Increase in first morning voided urinary luteinizing hormone levels precedes the physical onset of puberty. J Clin Endocrinol Metab. 1996, 81: 2963-7. 10.1210/jc.81.8.2963.PubMed Demir A, Voutilainen R, Juul A, Dunkel L, Alfthan H, Skakkebaek NE, Stenman UH: Increase in first morning voided urinary luteinizing hormone levels precedes the physical onset of puberty. J Clin Endocrinol Metab. 1996, 81: 2963-7. 10.1210/jc.81.8.2963.PubMed
9.
go back to reference Maesaka H, Tachibana K, Adachi M, Okada T: Monthly urinary gonadotropin and ovarian hormone excretory patterns in normal girls and female patients with idiopathic precocious puberty. Pediatr Res. 1996, 40: 853-60. 10.1203/00006450-199612000-00013.CrossRefPubMed Maesaka H, Tachibana K, Adachi M, Okada T: Monthly urinary gonadotropin and ovarian hormone excretory patterns in normal girls and female patients with idiopathic precocious puberty. Pediatr Res. 1996, 40: 853-60. 10.1203/00006450-199612000-00013.CrossRefPubMed
10.
go back to reference Oosterhuis GJ, Vermes I, Michgelsen HW, Schoemaker J, Lambalk CB: Follicle stimulating hormone measured in unextracted urine throughout the menstrual cycle correlates with age and ovarian reserve. Hum Reprod. 2002, 17: 641-6. 10.1093/humrep/17.3.641.CrossRefPubMed Oosterhuis GJ, Vermes I, Michgelsen HW, Schoemaker J, Lambalk CB: Follicle stimulating hormone measured in unextracted urine throughout the menstrual cycle correlates with age and ovarian reserve. Hum Reprod. 2002, 17: 641-6. 10.1093/humrep/17.3.641.CrossRefPubMed
11.
go back to reference Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA: Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child. 1995, 73: 17-24. 10.1136/adc.73.1.17.PubMedCentralCrossRefPubMed Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA: Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child. 1995, 73: 17-24. 10.1136/adc.73.1.17.PubMedCentralCrossRefPubMed
12.
go back to reference Apter D, Bützow TL, Laughlin GA, Yen SS: Gonadotropin-releasing hormone pulse generator activity during pubertal transition in girls: pulsatile and diurnal patterns of circulating gonadotropins. J Clin Endocrinol Metab. 1993, 76: 940-9. 10.1210/jc.76.4.940.PubMed Apter D, Bützow TL, Laughlin GA, Yen SS: Gonadotropin-releasing hormone pulse generator activity during pubertal transition in girls: pulsatile and diurnal patterns of circulating gonadotropins. J Clin Endocrinol Metab. 1993, 76: 940-9. 10.1210/jc.76.4.940.PubMed
Metadata
Title
Urinary gonadotrophins: a useful non-invasive marker of activation of the hypothalamic pituitary-gonadal axis
Authors
Jane D McNeilly
Avril Mason
Sheila Khanna
Peter J Galloway
S Faisal Ahmed
Publication date
01-12-2012
Publisher
BioMed Central
Published in
International Journal of Pediatric Endocrinology / Issue 1/2012
Electronic ISSN: 1687-9856
DOI
https://doi.org/10.1186/1687-9856-2012-10

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