Nocturnal Urinary Excretion of FSH and LH in Children and Adolescents With Normal and Early Puberty
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Nocturnal Urinary Excretion of FSH and LH in Children and Adolescents With Normal and Early Puberty. / Kolby, Nanna; Busch, Alexander S.; Aksglaede, Lise; Sørensen, Kaspar; Petersen, Jorgen Holm; Andersson, Anna-Maria; Juul, Anders.
I: The Journal of Clinical Endocrinology & Metabolism, Bind 102, Nr. 10, 2017, s. 3830-3838.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Nocturnal Urinary Excretion of FSH and LH in Children and Adolescents With Normal and Early Puberty
AU - Kolby, Nanna
AU - Busch, Alexander S.
AU - Aksglaede, Lise
AU - Sørensen, Kaspar
AU - Petersen, Jorgen Holm
AU - Andersson, Anna-Maria
AU - Juul, Anders
PY - 2017
Y1 - 2017
N2 - Context: Clinical use of single serum gonadotropin measurements in children is limited by thepulsatile secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). However,first morning voided (FMV) urine may integrate the fluctuating gonadotropin serum levels.Objective: We aimed to evaluate urinary and serum gonadotropin levels according to age, sex, andpubertal stage in healthy children and to assess the clinical use of FMV urinary gonadotropins inchildren with disordered puberty.Design: Cross-sectional part of the COPENHAGEN Puberty Study and longitudinal study of patients.Setting: Population-based and outpatient clinic.Patients or Other Participants: Eight hundred forty-three healthy children from the COPENHAGENPuberty Study and 25 girls evaluated for central precocious puberty (CPP).Main Outcome Measures: Clinical pubertal staging, including serum and urinary gonadotropin levels.Results: Urinary gonadotropins increased with advancing age and pubertal development and weredetectable in FMV urine before physical signs of puberty. FMV urinary LH correlated strongly withbasal (r = 0.871, P , 0.001) and gonadotropin-releasing hormone (GnRH)-stimulated serum LH(r = 0.82, P , 0.001). Urinary LH was superior to urinary FSH in differentiating the pubertal stage.Receiver operating curve analysis revealed that a cut-off standard deviation (SD) score of 2 forurinary LH (IU/L) gave a sensitivity of 75% and a specificity of 92% in predicting a positive GnRHstimulation test (LHmax . 5 IU/L). Urinary concentrations of LH decreased after 3 months of GnRHtreatment to levels below +2 SDs.Conclusions: Urinary gonadotropin levels increased before the onset of puberty and were elevatedin girls with CPP. We suggest urinary LH as an alternative noninvasive method to improve diagnosingand therapeutic management of children with disordered puberty.
AB - Context: Clinical use of single serum gonadotropin measurements in children is limited by thepulsatile secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). However,first morning voided (FMV) urine may integrate the fluctuating gonadotropin serum levels.Objective: We aimed to evaluate urinary and serum gonadotropin levels according to age, sex, andpubertal stage in healthy children and to assess the clinical use of FMV urinary gonadotropins inchildren with disordered puberty.Design: Cross-sectional part of the COPENHAGEN Puberty Study and longitudinal study of patients.Setting: Population-based and outpatient clinic.Patients or Other Participants: Eight hundred forty-three healthy children from the COPENHAGENPuberty Study and 25 girls evaluated for central precocious puberty (CPP).Main Outcome Measures: Clinical pubertal staging, including serum and urinary gonadotropin levels.Results: Urinary gonadotropins increased with advancing age and pubertal development and weredetectable in FMV urine before physical signs of puberty. FMV urinary LH correlated strongly withbasal (r = 0.871, P , 0.001) and gonadotropin-releasing hormone (GnRH)-stimulated serum LH(r = 0.82, P , 0.001). Urinary LH was superior to urinary FSH in differentiating the pubertal stage.Receiver operating curve analysis revealed that a cut-off standard deviation (SD) score of 2 forurinary LH (IU/L) gave a sensitivity of 75% and a specificity of 92% in predicting a positive GnRHstimulation test (LHmax . 5 IU/L). Urinary concentrations of LH decreased after 3 months of GnRHtreatment to levels below +2 SDs.Conclusions: Urinary gonadotropin levels increased before the onset of puberty and were elevatedin girls with CPP. We suggest urinary LH as an alternative noninvasive method to improve diagnosingand therapeutic management of children with disordered puberty.
U2 - 10.1210/jc.2017-01192
DO - 10.1210/jc.2017-01192
M3 - Journal article
C2 - 28938419
VL - 102
SP - 3830
EP - 3838
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 10
ER -
ID: 196204712