title: First Morning Voided Urinary Gonadotropin Measurements as an Alternative to the GnRH Test.
abstract: OBJECTIVE
  We studied whether first morning voided (FMV) urinary gonadotropin measurements could be used as a noninvasive alternative to the GnRH test in the assessment of the hypothalamic-pituitary-gonadal function in children.
  
  
  METHODS
  In a single-center study, we compared FMV urinary gonadotropin concentrations with basal and GnRH-stimulated serum gonadotropin levels in 274 children and adolescents (78 girls, 196 boys) aged 5-17 years referred for growth and pubertal disorders. The concordance between FMV urinary gonadotropin concentrations and GnRH test results was assessed.
  
  
  RESULTS
  FMV urinary LH (U-LH), urinary FSH (U-FSH) and their ratios correlated well with the corresponding basal and GnRH-stimulated serum parameters (r ≥ 0.66, p < 0.001). Receiver operating characteristic curve analyses using urinary and serum LH and FSH concentrations showed that FMV U-LH and U-LH/U-FSH performed equally well as the GnRH test in the differentiation of early puberty (Tanner stage 2) from prepuberty (Tanner stage 1) (area under the curve 0.768-0.890 vs. 0.712-0.858). FMV U-LH and U-LH/U-FSH performed equally well as basal serum LH in predicting a pubertal GnRH test result (area under the curve 0.90-0.93).
  
  
  CONCLUSIONS
  FMV U-LH determination can be used for the evaluation of pubertal development and its disorders, reducing the need for invasive GnRH stimulation tests.
authors.affiliation: Children's Hospital, Helsinki, Finland.
authors.forename: And
authors.initials: A
authors.lastname: Demir
authors.forename: Raimo
authors.initials: R
authors.lastname: Voutilainen
authors.forename: Ulf-Håkan
authors.initials: UH
authors.lastname: Stenman
authors.forename: Leo
authors.initials: L
authors.lastname: Dunkel
authors.forename: Kerstin
authors.initials: K
authors.lastname: Albertsson-Wikland
authors.forename: Ensio
authors.initials: E
authors.lastname: Norjavaara
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006062:Gonadotropins / Q000652:urine*; D006801:Humans; D008297:Male; D011627:Puberty / Q000652:urine*
chemical_list: D006062:Gonadotropins