Maesaka H, Tachibana K, Adachi M, Okada T
Department of Pediatrics, Kanagawa Children's Medical Center, Yokohama, Japan.
Pediatr Res. 1996 Dec;40(6):853-60. doi: 10.1203/00006450-199612000-00013.
To identify the developmental changes in monthly urinary gonadotropin and ovarian hormone excretion, consecutive 30-d first morning void urinary specimens were collected from 36 normal girls, one normal woman, and 15 female patients with idiopathic precocious puberty. Of these children, three normal girls and three patients with precocious puberty volunteered to collect these specimens on 2-3 occasions over a time interval of 0.5-3.2 y. When sampled, six were early prepubertal, nine late prepubertal, eight early pubertal, eight mid-pubertal, and eight late pubertal normal girls, and six were early pubertal and 14 mid-pubertal patients with precocious puberty. The mean level of monthly urinary LH, FSH, and total estrogen excretions increased with pubertal maturation. In prepuberty, the mean LH level was lower than the mean FSH level, and neither showed significant episodic fluctuations. In early puberty, mean FSH levels increased with remarkable fluctuations, and mean LH levels were low with few variations in the course of a month. At the onset of puberty, gonadotropin excretory patterns underwent specific changes, showing at the same time periodically and every other day fluctuating patterns. Urinary total estrogen and pregnanediol excretion fluctuated independently from these periodic variations in urinary gonadotropins. These patterns were observed in six out of 16 patterns in normal pubertal girls and 10 out of 20 patterns in precocious puberty. Once the urine LH level exceeded the urine FSH level, however, these periodic variations disappeared. The cycle of a normal postmenarcheal girl aged 14 y showed a pattern similar to that of a normal adult. In patients with precocious puberty, the hormonal patterns were similar to those of sexual stage-matched normal girls.
为了确定每月尿促性腺激素和卵巢激素排泄的发育变化，我们从36名正常女孩、1名正常女性和15名特发性性早熟女性患者中收集了连续30天的首次晨尿标本。在这些儿童中，3名正常女孩和3名性早熟患者自愿在0.5 - 3.2年的时间间隔内分2 - 3次收集这些标本。采样时，6名是青春期前早期，9名是青春期前晚期，8名是青春期早期，8名是青春期中期，8名是青春期晚期正常女孩，6名是青春期早期和14名青春期中期性早熟患者。每月尿促黄体生成素（LH）、促卵泡生成素（FSH）和总雌激素排泄的平均水平随着青春期成熟而增加。青春期前，平均LH水平低于平均FSH水平，且两者均未显示出明显的周期性波动。青春期早期，平均FSH水平显著波动升高，而平均LH水平较低，在一个月内变化很少。青春期开始时，促性腺激素排泄模式发生特定变化，同时呈现出周期性和隔日波动模式。尿总雌激素和孕二醇排泄与尿促性腺激素的这些周期性变化独立波动。这些模式在正常青春期女孩的16种模式中有6种观察到，在性早熟的20种模式中有10种观察到。然而，一旦尿LH水平超过尿FSH水平，这些周期性变化就消失了。一名14岁月经初潮后正常女孩的周期显示出与正常成年人相似的模式。在性早熟患者中，激素模式与性发育阶段匹配的正常女孩相似。
