Chellakooty M, Schmidt I M, Haavisto A M, Boisen K A, Damgaard I N, Mau C, Petersen J H, Juul A, Skakkebaek N E, Main K M
University Department of Growth and Reproduction, Rigshospitalet, DK-2100 Copenhagen, Denmark.
J Clin Endocrinol Metab. 2003 Aug;88(8):3515-20. doi: 10.1210/jc.2002-021468.
The early postnatal regulation of reproductive hormones seems to be more complex in girls than in boys. The aim of this study was to describe inhibins A and B, FSH, LH, estradiol, and SHBG in a large prospective cohort of 473 unselected, healthy, 3-month-old girls. In full term, appropriate-for- gestational-age girls (n = 355) hormones showed a marked interindividual variation, with concentrations up to pubertal values [medians (95% confidence intervals): inhibin B, 82 pg/ml (<20-175); FSH, 3.8 IU/liter (1.2-18.8); LH, 0.07 IU/liter (<0.05-1.07); estradiol, 31 pM (<18-83); SHBG, 137 nM (72-260)]. In 38%, FSH levels exceeded 4.5 IU/liter. Weight at 3 months had significant inverse relationships with estradiol and SHBG (P = 0.048 and P = 0.001, respectively). Gestational age was negatively correlated to estradiol (P = 0.001), with a similar trend for LH, FSH, and inhibin B. Inhibin B was higher in premature girls [126 pg/ml (<20-265)] than in term [80 pg/ml (<20-181), P = 0.002] and postmature girls [59 pg/ml (<20-152), P = 0.012]. Likewise, estradiol levels in prematures were higher than in mature girls [51 pM (<18-128) vs. 31 pM (<18-85), P = 0.009]. Estradiol was also higher in small-for-gestational-age than in appropriate-for-gestational-age girls (P = 0.046), with inhibin B and LH, but not FSH, showing a similar trend. In conclusion, reproductive hormones showed a large variation, and concentrations corresponded to those observed in puberty. Our findings support the concept of a minipuberty in infant girls similar to that in boys.
女孩出生后早期生殖激素的调节似乎比男孩更为复杂。本研究的目的是描述473名未经挑选的、健康的3个月大女孩的大型前瞻性队列中的抑制素A和B、促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇和性激素结合球蛋白(SHBG)。在足月、适于胎龄的女孩(n = 355)中,激素显示出明显的个体间差异,浓度可达青春期水平[中位数(95%置信区间):抑制素B,82 pg/ml(<20 - 175);FSH,3.8 IU/L(1.2 - 18.8);LH,0.07 IU/L(<0.05 - 1.07);雌二醇,31 pM(<18 - 83);SHBG,137 nM(72 - 260)]。38%的女孩FSH水平超过4.5 IU/L。3个月时的体重与雌二醇和SHBG呈显著负相关(分别为P = 0.048和P = 0.001)。胎龄与雌二醇呈负相关(P = 0.001),LH、FSH和抑制素B也有类似趋势。早产女孩的抑制素B[126 pg/ml(<20 - 265)]高于足月女孩[80 pg/ml(<20 - 181),P = 0.002]和过期产女孩[59 pg/ml(<20 - 152),P = 0.012]。同样,早产女孩的雌二醇水平高于足月女孩[51 pM(<18 - 128)对31 pM(<18 - 85),P = 0.009]。小于胎龄儿的雌二醇水平也高于适于胎龄的女孩(P = 0.046),抑制素B和LH也有类似趋势,但FSH没有。总之,生殖激素显示出很大的差异,其浓度与青春期观察到的浓度相当。我们的研究结果支持女婴存在与男婴类似的小青春期这一概念。