Sørensen K, Andersson A M, Skakkebaek N E, Juul A
University Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
J Clin Endocrinol Metab. 2007 Aug;92(8):3189-96. doi: 10.1210/jc.2007-0231. Epub 2007 May 22.
The regulation of SHBG is complex and influenced by sex steroids and insulin.
Our objective was to describe serum levels and evaluate determinants of SHBG levels in healthy children and in girls with central precocious puberty (CPP) before and during GnRH analog (GnRHa) treatment.
We conducted a cross-sectional study on healthy subjects and a 2-yr longitudinal study in girls with CPP.
The study took place at a tertiary referral center for pediatric endocrinology.
PARTICIPANTS/PATIENTS: A total of 903 healthy schoolchildren served as healthy subjects, and 25 girls with precocious/early puberty participated.
Girls with CPP were treated with the long-acting GnRHa triptorelin.
SHBG levels declined with increasing age in both sexes until adulthood. In healthy children, SHBG was significantly negatively correlated with testosterone, estradiol, dehydroepiandrosterone sulfate, and body mass index (BMI) in boys (total model R(2) = 0.71) but only with dehydroepiandrosterone sulfate and BMI in girls (total model R(2) = 0.26). Body fat percentage was significantly negatively correlated with SHBG levels (P < 0.001) in both boys (R(2) = 0.18) and girls (R(2) = 0.23). Girls with CPP had significantly lower pretreatment SHBG levels compared with age-matched controls [SHBG sd score, -1.29 (-4.48; 0.01)], which declined even further during GnRHa treatment [-2.75 (-5.9; 0.53); P < 0.001]. Even after adjustment for BMI and pubertal stage, girls with CPP had lower SHBG levels (P < 0.001) compared with healthy controls.
SHBG levels were strongly dependent on body composition and sex steroid levels in children with normal and precocious puberty. Studies on insulin sensitivity and SHBG in puberty are needed to better understand the interaction between body composition and gonadal maturation.
性激素结合球蛋白（SHBG）的调节机制复杂，受性类固醇和胰岛素影响。
我们的目的是描述健康儿童以及中枢性性早熟（CPP）女童在GnRH类似物（GnRHa）治疗前及治疗期间的血清SHBG水平，并评估其影响因素。
我们对健康受试者进行了横断面研究，并对CPP女童进行了为期2年的纵向研究。
研究在一家儿科内分泌三级转诊中心进行。
参与者/患者：共有903名健康学童作为健康受试者，25名性早熟/青春期过早女童参与研究。
CPP女童接受长效GnRHa曲普瑞林治疗。
两性的SHBG水平均随年龄增长而下降，直至成年。在健康儿童中，男孩的SHBG与睾酮、雌二醇、硫酸脱氢表雄酮和体重指数（BMI）显著负相关（总模型R² = 0.71），而女孩仅与硫酸脱氢表雄酮和BMI负相关（总模型R² = 0.26）。男孩（R² = 0.18）和女孩（R² = 0.23）的体脂百分比均与SHBG水平显著负相关（P < 0.001）。与年龄匹配的对照组相比，CPP女童治疗前的SHBG水平显著较低[SHBG标准差评分，-1.29（-4.48；0.01）]，在GnRHa治疗期间进一步下降[-2.75（-5.9；0.53）；P < 0.001]。即使在调整BMI和青春期阶段后，CPP女童的SHBG水平仍低于健康对照组（P < 0.001）。
正常和早熟儿童的SHBG水平强烈依赖于身体组成和性类固醇水平。需要开展关于青春期胰岛素敏感性和SHBG的研究，以更好地理解身体组成与性腺成熟之间的相互作用。
