title: Complex biological pattern of fertility hormones in children and adolescents: a study of healthy children from the CALIPER cohort and establishment of pediatric reference intervals.
abstract: BACKGROUND
  Pediatric endocrinopathies are commonly diagnosed and monitored by measuring hormones of the hypothalamic-pituitary-gonadal axis. Because growth and development can markedly influence normal circulating concentrations of fertility hormones, accurate reference intervals established on the basis of a healthy, nonhospitalized pediatric population and that reflect age-, gender-, and pubertal stage-specific changes are essential for test result interpretation.
  
  
  METHODS
  Healthy children and adolescents (n = 1234) were recruited from a multiethnic population as part of the CALIPER study. After written informed parental consent was obtained, participants filled out a questionnaire including demographic and pubertal development information (assessed by self-reported Tanner stage) and provided a blood sample. We measured 7 fertility hormones including estradiol, testosterone (second generation), progesterone, sex hormone-binding globulin, prolactin, follicle-stimulating hormone, and luteinizing hormone by use of the Abbott Architect i2000 analyzer. We then used these data to calculate age-, gender-, and Tanner stage-specific reference intervals according to Clinical Laboratory Standards Institute C28-A3 guidelines.
  
  
  RESULTS
  We observed a complex pattern of change in each analyte concentration from the neonatal period to adolescence. Consequently, many age and sex partitions were required to cover the changes in most fertility hormones over this period. An exception to this was prolactin, for which no sex partition and only 3 age partitions were necessary.
  
  
  CONCLUSIONS
  This comprehensive database of pediatric reference intervals for fertility hormones will be of global benefit and should lead to improved diagnosis of pediatric endocrinopathies. The new database will need to be validated in local populations and for other immunoassay platforms as recommended by the Clinical Laboratory Standards Institute.
authors: Caliper Program, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Danijela
authors: D
authors: Konforte
authors: Jennifer L
authors: JL
authors: Shea
authors: Lianna
authors: L
authors: Kyriakopoulou
authors: David
authors: D
authors: Colantonio
authors: Ashley H
authors: AH
authors: Cohen
authors: Julie
authors: J
authors: Shaw
authors: Dana
authors: D
authors: Bailey
authors: Man Khun
authors: MK
authors: Chan
authors: David
authors: D
authors: Armbruster
authors: Khosrow
authors: K
authors: Adeli
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D042341:Gonadal Hormones / Q000097:blood*; D006801:Humans; D007118:Immunoassay; D007223:Infant; D007231:Infant, Newborn; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D036361:Peptide Hormones / Q000097:blood*; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D012016:Reference Values; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood
chemical_list: D042341:Gonadal Hormones; D036361:Peptide Hormones; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone