Urinary gonadotrophins: role in assessment and management of disorders of puberty

Abstract

Introduction: With improvements in assays and the increasing need for non-invasive, out-patient based investigations, there is a renewed interest in the use of urinary gonadotrophins (UG) for assessing pubertal progress. This study aims to establish the correlation between serum and urinary LH and FSH in patients undergoing investigation or management of pubertal disorders. Methods/design: Retrospective evaluation of eight patients undergoing investigation for pubertal delay (five males and three females) and 21 patients (six males and 15 females) for early puberty or suppression of puberty by GnRH agonist (GnRH-a) therapy. Median ages (range) for the boys and girls were 14.4 years (8.9–17.2) and 9.2 years (4.2–17.3), respectively. Non-timed spot urine samples were collected for all cases and 11 (five males and six females) of these were on GnRH-a. Of the 29 cases, matched serum gonadotrophins were available in 15 cases (seven males and eight females). UG were measured by chemiluminescent microparticle immunoassay and corrected for urinary creatinine. Results: In both pubertal males and females, UG were significantly higher than during-GnRH-a treatment: For the 15 cases with matched serum and urine samples, median serum LH and ULH:creat were 1.5 U/l (0.1–21.9) and 0.16 (0–1.37), respectively. There was a strong correlation between these values (r2, 0.92), independent of sex. Conclusion: These preliminary data suggest that UG reflect serum gonadotrophin concentrations and the finding of low UG in patients on GnRH-a therapy suggest that this test may represent a useful non-invasive method of assessing and monitoring effectiveness of GnRH-a therapy

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