{"doi":"10.1371/journal.pone.0251598","title":"Urinary and salivary endocrine measurements to complement Tanner staging in studies of pubertal development","abstract":"BACKGROUND: Many studies investigating pubertal development use Tanner staging to assess maturation. Endocrine markers in urine and saliva may provide an objective, sensitive, and non-invasive method for assessing development. OBJECTIVE: Our objective was to examine whether changes in endocrine levels can indicate the onset of pubertal development prior to changes in self-rated Tanner stage. METHODS: Thirty-five girls and 42 boys aged 7 to 15 years were enrolled in the Growth and Puberty (GAP) study, a longitudinal pilot study conducted from 2007-2009 involving children of women enrolled in the Agricultural Health Study (AHS) in Iowa. We collected saliva and urine samples and assessed pubertal development by self-rated Tanner staging (pubic hair, breast development (girls), genital development (boys)) at three visits over six months. We measured dehydroepiandrosterone (DHEA) in saliva and creatinine-adjusted luteinizing hormone (LH), testosterone, follicle stimulating hormone (FSH), estrone 3-glucuronide (E13G) and pregnanediol 3-glucuronide (Pd3G) concentrations in first morning urine. We evaluated the relationships over time between Tanner stage and each biomarker using repeated measures analysis. RESULTS: Among girls still reporting Tanner breast stage 1 at the final visit, FSH levels increased over the 6-month follow-up period and were no longer lower than higher stage girls at the end of follow-up. We observed a similar pattern for testosterone in boys. By visit 3, boys still reporting Tanner genital stage 1 or pubic hair stage 1 had attained DHEA levels that were comparable to those among boys reporting Tanner stages 2 or 3. CONCLUSIONS: Increasing concentrations of FSH in girls and DHEA and testosterone in boys over a 6-month period revealed the start of the pubertal process prior to changes in self-rated Tanner stage. Repeated, non-invasive endocrine measures may complement the more subjective assessment of physical markers in studies determining pubertal onset.","journal":"PLoS ONE","year":2021,"id":192907,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9405,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":761324,"name":"Anna J. Ciesielski Jones","orcid":null,"position":1,"is_corresponding":false},{"id":89235,"name":"John A. McGrath","orcid":"0000-0002-9756-7892","position":2,"is_corresponding":false},{"id":761325,"name":"Christie Barker‐Cummings","orcid":null,"position":3,"is_corresponding":false},{"id":612847,"name":"Deborah S. Cousins","orcid":"0000-0001-5468-9745","position":4,"is_corresponding":false},{"id":761326,"name":"Lauren M. Kipling","orcid":null,"position":5,"is_corresponding":false},{"id":522623,"name":"Juliana W. Meadows","orcid":null,"position":6,"is_corresponding":false},{"id":521874,"name":"James S. Kesner","orcid":"0000-0003-3348-4219","position":7,"is_corresponding":false},{"id":456660,"name":"Michele Marcus","orcid":"0000-0002-2052-1685","position":8,"is_corresponding":false},{"id":761327,"name":"Carolyn Monteilh","orcid":null,"position":9,"is_corresponding":false},{"id":104612,"name":"Dale P. Sandler","orcid":"0000-0002-6776-0018","position":10,"is_corresponding":false},{"id":281033,"name":"Mandy Goldberg","orcid":"0000-0002-6794-1206","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-18T23:49:47.463744Z","pmid":"33984062","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}