Random urinary gonadotropins as a useful initial test for girls with central precocious puberty

Abstract

Recent evidence indicates that urinary gonadotropins may be an alternative method for detecting pubertal disorders. The aim of this study was to evaluate the associations of first morning voided (FMV) and random urinary gonadotropins with the pubertal response to a gonadotropin-releasing hormone (GnRH) stimulation test to determine whether random urinary gonadotropins can be used as an alternative method for evaluating central precocious puberty (CPP). In total, 100 girls aged 6.0-8.9 years were enrolled. The subjects were divided into two groups according to their pubertal response to the GnRH stimulation test: a positive group (n = 68) and a negative group (n = 32). Random urinary luteinizing hormone (LH), follicle-stimulating hormone (FSH), and the LH:FSH ratio were significantly positively correlated with FMV urinary LH (r = 0.411, p < 0.001), FMV urinary FSH (r = 0.494, p < 0.001), and the FMV urinary LH:FSH ratio (r = 0.519, p < 0.001). The optimal cutoff values from receiver operating characteristic (ROC) curve analyses were determined to be 0.20 IU/L for random urinary LH (area under the curve (AUC) of 0.812, p < 0.001), 3.03 IU/L for random urinary FSH (AUC of 0.670, p = 0.004) and 0.08 for the random urinary LH:FSH ratio (AUC of 0.784, p < 0.001). No differences were observed between FMV and random urinary LH (p = 0.827), between FMV and random urinary FSH (p = 0.650), or between the FMV and random urinary LH:FSH ratio (p = 0.688) in ROC curve analyses with DeLong's test. Based on our findings, random urinary gonadotropins may be applicable in clinical practice as a useful initial test for girls with CPP.

The Use of Morning Urinary Gonadotropins and Sex Hormones in the Management of Early Puberty in Chinese Girls

“…Likewise, it was reported that a cutoff SD score of 2 for uLH had a sensitivity of 75% and a specificity of 92% in the COPENHAGEN puberty study with a large population ( 8 ). In another important study random urinary gonadotropins were recommended for the initial assessment of CPP in girls because there was no difference between FMV and random urinary gonadotropins levels ( 16 ). We consider that the main reason for various cutoff values was difference in sample size and hormone assay.…”

“…The value and reference of uLH in well-suppressed patients should be confirmed in large-scale and multicenter studies. In addition, randomized urinary gonadotropins were promising in clinical practice ( 16 ), so further work is required to clarify whether elevated randomized uLH is sufficiently sensitive to replace FMV uLH.…”

The value of urinary gonadotropins in the diagnosis of central precocious puberty: a meta-analysis

“…The sensitivity analysis illustrated that three studies in this meta-analysis might have caused bias, which referred to Shim et al’s [ 11 ], Yang et al’s [ 13 ] and Chen et al’s studies [ 14 ]. Subsequent sensitivity analyses were therefore conducted, and the results showed that the fourth record had the largest effect (Table 3 ).…”

“…The first included study not only evaluated the first-voided urinary gonadotropin levels but also tested random urinary gonadotropin levels; however, we only collected the first-voided urine results [ 11 ]. Only the value of ULH was examined in the second included study.…”

“…Thus, 11 full papers were reviewed. Finally, the eligibility criteria were fulfilled by 6 studies [11][12][13][14][15][16] involving 491 participants (Fig. 1).…”