Jiang You-jun, Chen Li-qin, Liang Li, Zou Chao-chun, Zhu Hong, Fu Jun-fen, Zhao Zheng-yan
Department of Endocrinology, The Affiliated Children's Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2005 Jul;34(4):308-11, 319. doi: 10.3785/j.issn.1008-9292.2005.04.005.
To investigate the relationship of serum dehydroepiandrosterone (DHEA) levels and female precocious puberty.
The serum levels of DHEA and dehydroepiandrosterone sulfate (DHEAS) were measured by ELISA in 60 idiopathic central precocious puberty (ICPP) girls, 62 premature thelarche (PT) girls and 31 age-matched health prepuberty girls. Bone age,volume of uterus and ovary, DHEA and DHEAS were re-measured in 3, 12 months after treatment with Diphereline in ICPP girls.
(1) The Log(DHEA) and Log(DHEAS) were (0.81 +/-0.36)microg/L and (2.31 +/-0.31)microg/L in ICPP group, (0.72 +/-0.30)microg/L and (2.31 +/-0.28)mg/L in PT group, and (0.32 +/-0.26)microg/L and (2.16+/-0.27)microg/L in controls (P <0.05). However, no significant differences were found between ICPP and PT group (P >0.05). Moreover, the serum levels of DHEA and DHEAS in precocious puberty girls with Tanner III stage were significant higher than those with Tanner II stage (P <0.05). (2) With bivariate correlation analysis, Log(DHEA) was positively correlated with height, bone age, volume of uterus and ovary (r=0.429, 0.339, 0.217, 0.282; all P<0.05), while no significant correlation with Log(LH peak), Log(FSH peak) and BMI (r=0.135, -0.165, 0.059). Log(DHEAS) was positively correlated with height,bone age and volume of ovary (r=0.319, 0.210, 0.181; P <0.05), while no correlated with Log(LH peak), Log(FSH peak), volume of uterus and BMI (r=0.012, -0.173, 0.146 and 0.081 respectively). (3) Serum Log (DHEA) and Log(DHEAS) of 32 ICPP were decreased from (0.83 +/-0.35) microg/L and (2.27 +/-0.30)microg/L to (0.68 +/-0.44)microg/L and (2.11 +/-0.43)microg/L (P<0.05) 3 months after treatment. The serum Log(DHEA) and Log(DHEAS) in 12 months after treatment were (0.78 +/-0.30)microg/L and (2.40+/-0.34)microg/L, which was not significantly different with that before treatment (P>0.05). However, the volume of uterus and ovary, bone age/age in 12 months after treatment were significantly different with those before treatment (2.82 +/-1.52 compared with 1.09 +/-0.50 ml, 3.15 +/-1.13 compared with 1.18 +/-0.42 ml, 1.43 +/-0.23 compared with 1.25 +/-0.12, all P<0.05).
(1) The serum levels of DHEA and DHEAS are increased in precocious puberty girls with the development of Tanner stage. (2) Serum levels of DHEA and DHEAS are declined transiently when the hypothalamic-pituitary-gonadal axis is inhibited. (3) Serum DHEA is associated with the acceleration of growth and bone age in precocious puberty girls.
探讨血清脱氢表雄酮（DHEA）水平与女性性早熟的关系。
采用酶联免疫吸附测定法（ELISA）检测60例特发性中枢性性早熟（ICPP）女童、62例单纯性乳房早发育（PT）女童及31例年龄匹配的青春前期健康女童的血清DHEA和硫酸脱氢表雄酮（DHEAS）水平。对ICPP女童应用达必佳治疗3个月、12个月后再次检测骨龄、子宫及卵巢容积、DHEA和DHEAS水平。
（1）ICPP组Log（DHEA）和Log（DHEAS）水平分别为（0.81±0.36）μg/L和（2.31±0.31）μg/L，PT组分别为（0.72±0.30）μg/L和（2.31±0.28）μg/L，对照组分别为（0.32±0.26）μg/L和（2.16±0.27）μg/L（P<0.05）。然而，ICPP组与PT组之间差异无统计学意义（P>0.05）。此外， Tanner III期性早熟女童血清DHEA和DHEAS水平显著高于Tanner II期（P<0.05）。（2）双变量相关性分析显示，Log（DHEA）与身高、骨龄、子宫及卵巢容积呈正相关（r=0.429、0.339、0.217、0.282；均P<0.05），而与Log（LH峰值）、Log（FSH峰值）及BMI无显著相关性（r=0.135、-0.165、0.059）。Log（DHEAS）与身高、骨龄及卵巢容积呈正相关（r=0.319、0.210、0.181；P<0.05），而与Log（LH峰值）、Log（FSH峰值）、子宫容积及BMI无相关性（r分别为0.012、-0.173、0.146及0.081）。（3）32例ICPP女童治疗3个月后血清Log（DHEA）和Log（DHEAS）水平由（0.83±0.35）μg/L和（2.27±0.30）μg/L降至（0.68±0.44）μg/L和（2.11±0.43）μg/L（P<0.05）。治疗12个月后血清Log（DHEA）和Log（DHEAS）水平分别为（0.78±0.30）μg/L和（2.40±0.34）μg/L，与治疗前相比差异无统计学意义（P>0.05）。然而，治疗12个月后子宫及卵巢容积、骨龄/年龄与治疗前相比差异有统计学意义（分别为2.82±1.52 ml与1.09±0.50 ml、3.15±1.13 ml与1.18±0.42 ml、1.43±0.23与1.25±0.12，均P<0.05）。
（1）随着Tanner分期进展，性早熟女童血清DHEA和DHEAS水平升高。（2）下丘脑-垂体-性腺轴被抑制时，血清DHEA和DHEAS水平短暂下降。（3）血清DHEA与性早熟女童生长加速及骨龄增加有关。
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