title: The measurement of urinary gonadotropins for assessment and management of pubertal disorder.
abstract: OBJECTIVE
  Measurement of urinary LH (uLH) and FSH (uFSH) may facilitate non-invasive pubertal assessment but there is a need for further validation by studying children and adolescents with disorders of puberty.
  
  
  METHODS
  65 cases (Male: 25) with a median age of 12 years (2.9-18.1) supplied at least one non-timed urine sample for uLH and uFSH measurement by immunoassay and corrected for creatinine excretion. 25 cases were receiving GnRH-agonist (GnRH-a) at the time of sample collection. In 41 cases, urine samples were collected prior to a LHRH test and in 12 cases matched serum samples for basal LH (sLH) and FSH (sFSH) were also available.
  
  
  RESULTS
  There was a significant correlation between sLH and uLH:uCr (r=0.82; p-value <0.001) and sFSH and uFSH:uCr (r=0.93; p-value <0.001). Based on receiver operator characteristics analysis, a uLH:uCr value of 0.05 IU/mmol as a cut-off would detect a LH peak >5U I/L with a sensitivity of 86% and a specificity of 72% with a positive predictive value of 93%. In pubertal boys (6) and girls (22) with a sLH peak >5UI/L, median uLH:uCr was 0.27 IU/mmol (0.27-0.28) and 0.17 IU/mmol (0.09-0.43), respectively. The median uFSH:uCr was 0.51 IU/mmol (0.41-0.60) for boys and 1.1 IU/mmol (0.21-2.44) for girls. In the 25 cases on GnRH-a, the median uLH:uCr for boys and girls was 0.02 IU/mmol (0.01-0.02) and 0.02 IU/mmol (0.004-0.07), respectively, and the median uFSH:uCr was 0.07 IU/mmol (0.05-0.09) and 0.27 IU/mmol (0.09-0.54), respectively.
  
  
  CONCLUSIONS
  Urinary gonadotrophins reflect serum gonadotrophin concentration and may represent a reliable non-invasive method of assessing pubertal progress.
authors.affiliation: Developmental Endocrinology Research Group, School of Medicine, Royal Hospital for Children, South Glasgow University Hospital Campus, University of Glasgow, 1345 Govan Road, Glasgow, G51 4TF, UK.|Post-graduate School of Paediatrics, Departments of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena & Reggio Emilia, Paediatric Unit, Modena, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Lucaccioni
authors.affiliation: Department of Biochemistry, Queen Elizabeth University Hospital, Glasgow, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: McNeilly
authors.affiliation: Developmental Endocrinology Research Group, School of Medicine, Royal Hospital for Children, South Glasgow University Hospital Campus, University of Glasgow, 1345 Govan Road, Glasgow, G51 4TF, UK.
authors.forename: Avril
authors.initials: A
authors.lastname: Mason
authors.affiliation: Pediatric Unit, Pediatric Endocrinology Clinic Carlo Poma Hospital, Strada Lago Paiolo, Mantua, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Giacomozzi
authors.affiliation: Developmental Endocrinology Research Group, School of Medicine, Royal Hospital for Children, South Glasgow University Hospital Campus, University of Glasgow, 1345 Govan Road, Glasgow, G51 4TF, UK.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kyriakou
authors.affiliation: Developmental Endocrinology Research Group, School of Medicine, Royal Hospital for Children, South Glasgow University Hospital Campus, University of Glasgow, 1345 Govan Road, Glasgow, G51 4TF, UK.
authors.forename: Mohammed Guftar
authors.initials: MG
authors.lastname: Shaikh
authors.affiliation: Post-graduate School of Paediatrics, Departments of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena & Reggio Emilia, Paediatric Unit, Modena, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Iughetti
authors.affiliation: Developmental Endocrinology Research Group, School of Medicine, Royal Hospital for Children, South Glasgow University Hospital Campus, University of Glasgow, 1345 Govan Road, Glasgow, G51 4TF, UK. Faisal.ahmed@glasgow.ac.uk.
authors.forename: Syed Faisal
authors.initials: SF
authors.lastname: Ahmed
mesh_terms: D000293:Adolescent; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002648:Child; D002675:Child, Preschool; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000097:blood / Q000652:urine*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood / Q000652:urine*; D008297:Male; D011237:Predictive Value of Tests; D011627:Puberty / Q000097:blood / Q000652:urine*; D011628:Puberty, Delayed / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000652:urine*; D011629:Puberty, Precocious / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000652:urine*; D012372:ROC Curve; D015203:Reproducibility of Results; D016482:Urinalysis
chemical_list: D015415:Biomarkers; D043373:Follicle Stimulating Hormone, Human; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone