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

Mcneilly, Mason Avril, Khanna Sheila, Galloway, Ahmed, Ahmed S

Description

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.

Sujets

• Adolescence
• Assessment
• FSH
• LH
• Puberty

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 5
• Langue: English

Extrait

McNeillyet al. International Journal of Pediatric Endocrinology2012,2012:10 http://www.ijpeonline.com/content/2012/1/10

R E S E A R C HOpen Access Urinary gonadotrophins: a useful noninvasive marker of activation of the hypothalamic pituitarygonadal axis 1 22 12,3* Jane D McNeilly , Avril Mason , Sheila Khanna , Peter J Gallowayand S Faisal Ahmed

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 (pHowever,= 0.006). 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. Keywords:Adolescence, Assessment, FSH, LH, Puberty

Introduction At present there are no practical noninvasive screening investigations to assess the activation and progression of the hypothalamicpituitarygonadal (HPG) axis. Routine investigations rely on the measurement of serum gonado trophins before and after stimulation of gonadotrophic secretion by GnRH agonists and analysis of various differ ent plasma steroids. These tests are expensive, invasive and often require a visit to the hospital. In addition, they are not suited for situations where there is a need for serial biochemical monitoring.

* Correspondence: [e-mail] 2 Developmental Endocrinology Research Group, Royal Hospital for Sick Children, Glasgow UK 3 Section of Child Health, University of Glasgow, Royal Hospital for Sick Children, Glasgow G3 8SJ, UK Full list of author information is available at the end of the article

Analysis of urinary gonadotrophins in children was first reported almost 50 years ago [1,2] when highly labour intensive methods, requiring numerous pretreatment pro cedures and 24 hr urine collections were necessary. Subse quently, the development of more sensitive and specific automated immunoassays for gonadotrophins has led to a movement away from urine to serum as the sample of choice. However, measurement of urinary gonadotrophins may be of benefit in particular situations such as longitu dinal studies [3,4], neonates [5] and pubertal assessment [610]. The aims of this study were, initially, to determine whether measurement of urinary gonadotrophins could differentiate between physically pre and postpubertal chil dren and, secondly, to establish and validate normal urinary gonadotrophin ranges for healthy pre and postpubertal children.

© 2012 Mcneilly et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.