ESPE Abstracts

Introduction: Urinary gonadotrophins measurement is a noninvasive method for evaluation of pubertal development and may have utility in population studies.

Objectives: To investigate the utility of urinary gonadotrophins as a noninvasive biomarker of puberty in boys and girls.

Methods: School-based adolescent cohort study with two time points for collecting school time urine samples and self-reported assessment of puberty through the Pubertal Development Scale (PDS) approximately two years apart. FSH and LH were measured by immunoassay and corrected for creatinine excretion.

Results: A total of 941 samples from 741 girls and 1,198 samples from 899 boys aged between 11-16 years were analyzed. Samples were mainly collected at a median age of 12.3 yrs (range11.1,13.2) and 14.2 yrs (13.4,15.7); uFSH:Cr ratio showed median annual change of -0.101 IU/mmoL (95%[-0.143,-0.038]) for girls and -0.124 IU/mmoL (95%[-0.156,-0.090]) for boys; uLH:Cr ratio showed an annual change of +0.013 IU/mmoL (95%[0.004,0.020]) and +0.017 IU/mmoL (95%[0.012,0.021]) in girls and boys, respectively. The annual change for uLH:FSH ratio was +0.028 (95%[0.021,0.035]) and +0.035 (95%[0.027,0.043]) in girls and boys, respectively. Correlation coefficients between uFSH:Cr, uLH:Cr and uLH:FSH ratio with age in girls were r=-0.075, r=0.106 and r=0.148, respectively. In boys, correlation coefficients between uFSH:Cr, uLH:Cr and uLH:FSH ratio with age were r=-0.113, r=0.163 and r=0.287, respectively. In subgroup analysis of 59 samples from girls and 233 samples from boys, collected within 90 days of PDS, were analyzed for correlations with self-reported pubertal development. In girls, uFSH:Cr ratio showed negative correlation with self-report breast development (r=-0.52), composite PDS score (r=-0.53) and PDS-derived pubertal categories (r=-0.50); uLH:FSH ratio showed positive correlations with self-report breast development (r=0.29), self-report menarchal status(r=0.35), composite PDS score (r=0.39) and PDS-derived pubertal categories (r=0.45) and uLH:Cr ratio revealed negligible correlations. In boys, all three parameters revealed negligible correlations with self-reported pubertal development, PDS composite score and PDS-derived pubertal categories. In girls, ROC curve analysis showed that uLH:FSH ratio of 0.071 provided sensitivity of 80% and specificity of 65% to predict post-menarcheal status on PDS self-report.

Conclusions: In girls aged 11-16 years, increase in urinary LH:FSH ratio is associated with increase in self-report pubertal development and urinary LH:FSH ratio represents a valid non-invasive biomarker of puberty in population studies. Associations between urinary gonadotrophins and self-reported pubertal development in boys are negligible.