Riddick L M, Garibaldi L R, Wang M E, Senne A R, Klimah P E, Clark A T, Levine L S, Oberfield S E, Pang S Y
Department of Pediatrics, University of Illinois College of Medicine, Chicago 60612.
J Clin Endocrinol Metab. 1991 Jan;72(1):46-50. doi: 10.1210/jcem-72-1-46.
To investigate the role of adrenal androgens in 3 alpha-androstanediol glucuronide (3AG) production in childhood, we compared serum 3AG and androgen levels [dehydroepiandrosterone (DHEA), DHEA sulfate (DS), androstenedione (delta 4-A), and testosterone (T)] in 32 children with premature pubarche due to idiopathic premature adrenarche (IPA; n = 26), partial 21-hydroxylase deficiency (n = 2), or 3 beta-hydroxysteroid dehydrogenase deficiency (n = 4) with those in 36 normal prepubertal (18 males and 18 females) and 22 normal pubertal Tanner II-III subjects (10 males and 12 females). Serum 3AG (2.7 +/- 2.0 nmol/L) and all androgen concentrations in children with IPA were significantly higher (P less than 0.05-0.001) than those in normal prepubertal children (3AG, 0.8 +/- 0.5 nmol/L). Serum 3AG and androgen levels, except T, in all children with premature pubarche due to 21-hydroxylase deficiency or 3 beta-hydroxysteroid dehydrogenase deficiency were higher than those in the normal prepubertal children. Serum 3AG and all androgen levels in normal Tanner II-III male (3AG, 3.8 +/- 1.7 nmol/L) or female (3AG, 1.74 +/- 0.52 nmol/L) subjects were also significantly higher (P less than 0.05-0.001) than those in prepubertal children. Serum 3AG, DHEA, DS, and delta 4-A levels in children with IPA were similar to those in normal Tanner II-III females or males, but serum T in children with IPA (0.37 +/- 0.2 nmol/L) was significantly lower (P less than 0.05-0.001) than that in normal pubertal females (0.71 +/- 0.37 nmol/L) or males (4.5 +/- 2.6 nmol/L). In the combined group (n = 88), 3AG levels correlated better with serum DS (r = 0.7), DHEA (r = 0.6), and delta 4-A (r = 0.52), than with T (r = 0.31) levels. These data suggest that the weak adrenal androgens DS, DHEA, and delta 4-A contribute substantially to 3AG production in premature and normal pubarche.
为研究肾上腺雄激素在儿童期3α-雄烷二醇葡萄糖醛酸苷(3AG)生成中的作用,我们比较了32例因特发性性早熟肾上腺功能初现(IPA;n = 26)、部分21-羟化酶缺乏(n = 2)或3β-羟类固醇脱氢酶缺乏(n = 4)导致青春期阴毛早现的儿童与36例正常青春期前(18例男性和18例女性)及22例正常青春期坦纳II-III期受试者(10例男性和12例女性)的血清3AG和雄激素水平[脱氢表雄酮(DHEA)、硫酸脱氢表雄酮(DS)、雄烯二酮(δ4 - A)和睾酮(T)]。IPA患儿的血清3AG(2.7±2.0 nmol/L)和所有雄激素浓度显著高于正常青春期前儿童(3AG,0.8±0.5 nmol/L)(P<0.05 - 0.001)。因21-羟化酶缺乏或3β-羟类固醇脱氢酶缺乏导致青春期阴毛早现的所有儿童,其血清3AG和除T之外的雄激素水平均高于正常青春期前儿童。正常坦纳II-III期男性(3AG,3.8±1.7 nmol/L)或女性(3AG,1.74±0.52 nmol/L)受试者的血清3AG和所有雄激素水平也显著高于青春期前儿童(P<0.05 - 0.001)。IPA患儿的血清3AG、DHEA、DS和δ4 - A水平与正常坦纳II-III期女性或男性相似,但IPA患儿的血清T(0.37±0.2 nmol/L)显著低于正常青春期女性(0.71±0.37 nmol/L)或男性(4.5±2.6 nmol/L)(P<0.05 - 0.001)。在合并组(n = 88)中,3AG水平与血清DS(r = 0.7)、DHEA(r = 0.6)和δ4 - A(r = 0.52)的相关性优于与T(r = 0.31)水平的相关性。这些数据表明,弱肾上腺雄激素DS、DHEA和δ4 - A在青春期阴毛早现和正常青春期中对3AG的生成起重要作用。