采用新型超敏气相色谱-串联质谱法评估青春期前和青春期男孩和女孩的循环性激素水平。

Assessment of circulating sex steroid levels in prepubertal and pubertal boys and girls by a novel ultrasensitive gas chromatography-tandem mass spectrometry method.

机构信息

Laboratoire d'Etude des Résidus et Contaminants dans les Aliments, Unité Sous Contrat 2013 Institut National de la Recherche Agronomique, Ecole Nationale Vétérinaire de Nantes, F-44307 Nantes, France.

出版信息

J Clin Endocrinol Metab. 2010 Jan;95(1):82-92. doi: 10.1210/jc.2009-1140. Epub 2009 Nov 20.

DOI:10.1210/jc.2009-1140

PMID:19933393

Abstract

CONTEXT

Estrogens and androgens play key roles for pubertal onset and sexual maturation. Most currently used immunoassays are not sensitive enough to accurately measure the low circulating levels of sex steroids in children without any signs of puberty. However, this does not exclude that sex steroids have important biological roles in prepubertal children.

OBJECTIVES

To accurately determine levels of sex steroid hormones and their metabolites in serum of healthy children before any physical signs of puberty and to evaluate possible sex differences.

MAIN OUTCOME MEASURES

Total (unconjugated plus conjugated) serum levels of 17beta-testosterone, 17alpha-testosterone, 5alpha-dihydrotestosterone, 5beta-dihydrotestosterone, androsterone, etiocholanolone, estradiol, and estrone measured by an ultrasensitive method based on gas chromatography-tandem mass spectrometry in samples from 81 healthy schoolchildren (42 boys) without any signs of puberty. For comparison, 48 pubertal children were studied.

RESULTS

17beta-Estradiol levels in prepubertal boys were undetectable or extremely low (median < 3.7 pmol/liter), whereas levels in prepubertal girls were significantly higher (median 9.6 pmol/liter, P < 0.001). Among the older prepubertal children (>8 yr), girls had significantly higher androsterone (4.07 vs. 1.45 nmol/liter, P < 0.05), etiocholanolone (5.45 vs. 1.95 nmol/liter, P < 0.0001), 5alpha-dihydrotestosterone (0.11 vs. <0.10 nmol/liter, P < 0.01), and 17beta-testosterone concentrations (0.69 vs. 0.47 nmol/liter, P < 0.05) compared with similarly aged prepubertal boys.

CONCLUSION

Using an accurate and sensitive method, we found significantly higher levels of estrogens as well as androgen metabolites in prepubertal girls compared with age-matched boys. The higher prepubertal sex steroid levels in girls may contribute to their earlier onset of puberty including pubic hair development.

摘要

背景

雌激素和雄激素在青春期开始和性成熟中起着关键作用。大多数目前使用的免疫测定法不够敏感，无法准确测量没有任何青春期迹象的儿童的低循环性激素水平。然而，这并不排除性激素在青春期前儿童中具有重要的生物学作用。

目的

准确测定健康儿童在任何身体青春期迹象之前的血清中性激素激素及其代谢物的水平，并评估可能存在的性别差异。

主要观察结果

81 名健康学龄儿童（42 名男孩）血清中未结合加结合的 17β-睾酮、17α-睾酮、5α-二氢睾酮、5β-二氢睾酮、雄酮、表雄酮烷、雌二醇和雌酮的总水平，采用基于气相色谱-串联质谱的超灵敏方法进行测量，这些儿童均无任何青春期迹象。为了进行比较，还研究了 48 名青春期儿童。

结果

青春期前男孩的 17β-雌二醇水平无法检测或极低（中位数<3.7 pmol/L），而青春期前女孩的水平则明显较高（中位数 9.6 pmol/L，P<0.001）。在年龄较大的青春期前儿童（>8 岁）中，女孩的雄酮（4.07 对 1.45 nmol/L，P<0.05）、表雄酮烷（5.45 对 1.95 nmol/L，P<0.0001）、5α-二氢睾酮（0.11 对<0.10 nmol/L，P<0.01）和 17β-睾酮浓度（0.69 对 0.47 nmol/L，P<0.05）均明显高于同龄青春期前男孩。