ESPE Abstracts (2018) 89 P-P1-207

Urinary Gonadotropins as a Useful Non-invasive Marker of Central Precocious Puberty

Il Tae Hwang, Hwal Rim Jeong, Seung Yang & Young Suk Shim


Department of Pediatrics, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea


Aims: The current study aimed that first morning voided (FMV) urinary gonadotropin measurements could be used as a noninvasive alternative to the gonadotropin-releasing hormone (GnRH) test in the assessment of the hypothalamic-pituitary-gonadal function in children.

Methods: In a multi-center study, we compared FMV urinary gonadotropin concentrations with GnRH-stimulated serum gonadotropin levels in 140 girls aged 7–9 years who were evaluated for pubertal development, height acceleration, and bone maturation. Urinary and serum LH and FSH were determined by time-resolved sandwich fluoroimmunoassays (Delfia hLH Spec and Delfia hFSH; Wallac Oy, Turku, Finland). The relationship between FMV urinary gonadotropin concentrations and GnRH test results was assessed.

Results: FMV urinary LH (U-LH) and FMV urinary LH to FSH ratio (U-LH to U-FSH ratio) were significantly positively correlated with peak LH in GnRH stimulation test (r=0.49, P=0.030 and r=0.070, P<0.001). In receiver operating characteristic (ROC) curve analyses, the level of 0.89 for FMV U-LH was determined to be a possible cutoff to predicting a pubertal GnRH stimulation test result, with a sensitivity of 90.9%, a specificity of 77.8%, and area under the curve 0.49–1.00 (P=0.006).

Conclusion: FMV U-LH determination may be an alternative assessment for pubertal development and its disorders, reducing the need for invasive GnRH stimulation tests.

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