title: Requirement for specific gravity and creatinine adjustments for urinary steroids and luteinizing hormone concentrations in adolescents.
abstract: OBJECTIVE
  Urinary hormone concentrations are often adjusted to correct for hydration status. We aimed to determine whether first morning void urine hormones in growing adolescents require adjustments and, if so, whether urinary creatinine or specific gravity are better adjustments.
  
  
  METHODS
  The study population was adolescents aged 10.1 to 14.3 years initially who provided fasting morning blood samples at 0 and 12 months (n = 343) and first morning urine every three months (n = 644). Unadjusted, creatinine and specific gravity-adjusted hormonal concentrations were compared by Deming regression and Bland-Altman analysis and grouped according to self-rated Tanner stage or chronological age. F-ratios for self-rated Tanner stages and age groups were used to compare unadjusted and adjusted hormonal changes in growing young adolescents. Correlations of paired serum and urinary hormonal concentration of unadjusted and creatinine and specific gravity-adjusted were also compared.
  
  
  RESULTS
  Fasting first morning void hormone concentrations correlated well and were unbiased between unadjusted or adjusted by either creatinine or specific gravity. Urine creatinine concentration increases with Tanner stages, age and male gender whereas urine specific gravity was not influenced by Tanner stage, age or gender. Adjustment by creatinine or specific gravity of urinary luteinizing hormone, estradiol, testosterone, dihydrotestosterone and dehydroepiandrosterone concentrations did not improve correlation with paired serum concentrations.
  
  
  CONCLUSIONS
  Urine steroid and luteinizing hormone concentrations in first morning void samples of adolescents are not significantly influenced by hydration status and may not require adjustments; however, if desired, both creatinine and specific gravity adjustments are equally suitable.
authors.affiliation: Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, Australia Faculty of Pharmacy, Universiti Teknologi MARA, Bandar Puncak Alam, Selangor, Malaysia.
authors.forename: Gurmeet K S
authors.initials: GK
authors.lastname: Singh
authors.affiliation: Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Westmead, Australia Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Ben W R
authors.initials: BW
authors.lastname: Balzer
authors.affiliation: Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, Australia.
authors.forename: Reena
authors.initials: R
authors.lastname: Desai
authors.affiliation: Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Jimenez
authors.affiliation: Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Westmead, Australia Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Katharine S
authors.initials: KS
authors.lastname: Steinbeck
authors.affiliation: Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, Australia djh@anzac.edu.au.
authors.forename: David J
authors.initials: DJ
authors.lastname: Handelsman
mesh_terms: D000293:Adolescent; D002648:Child; D003404:Creatinine / Q000652:urine*; D005260:Female; D006801:Humans; D007986:Luteinizing Hormone / Q000652:urine*; D008297:Male; D011627:Puberty; D013046:Specific Gravity; D013256:Steroids / Q000652:urine*; D016482:Urinalysis / Q000379:methods*; D014554:Urination
chemical_list: D013256:Steroids; D007986:Luteinizing Hormone; D003404:Creatinine
keywords: Urine; adolescents; creatinine; luteinizing hormone; specific gravity; steroid hormones