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Open Access Research

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

Jane D McNeilly1, Avril Mason2, Sheila Khanna2, Peter J Galloway1 and S Faisal Ahmed23*

Author Affiliations

1 Department of Biochemistry, Royal Hospital for Sick Children, Glasgow, UK

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

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International Journal of Pediatric Endocrinology 2012, 2012:10  doi:10.1186/1687-9856-2012-10

Published: 4 May 2012

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.

Keywords:
Adolescence; Assessment; FSH; LH; Puberty